Patient attitudes to clozapine initiation
Clozapine is widely underused. No study has assessed views of patients suitable for, but not yet receiving, clozapine. We aimed to assess views of clozapine in patients eligible for clozapine but not yet prescribed it by conducting semistructured interviews with acutely unwell hospital in-patients. We interviewed 61 of 116 eligible patients and 50 (82%) answered all questions. At interview, 33 (54%) of 61 participants had heard of clozapine and 17 (30%) of 57 participants said they would take it if asked. Overall, 31 (57%) of 54 respondents said blood testing would not preclude them taking clozapine. The necessity for hosp...
Source: International Clinical Psychopharmacology - September 28, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Paliperidone palmitate 3-month treatment results in symptomatic remission in patients with schizophrenia: a randomized, multicenter, double-blind, and noninferiority study
The current analysis assessed symptomatic and functional remission achieved following paliperidone palmitate 3-month (PP3M) versus 1-month (PP1M) treatment in patients (age: 18–70 years) with schizophrenia, previously stabilized on PP1M. Following a less than or equal to 3-week screening, and a 17-week, flexible-dosed, open-label phase [PP1M: day 1 (150 mg eq. deltoid), day 8 (100 mg eq. deltoid), weeks 5, 9, and 13 (50, 75, 100, or 150 mg eq., deltoid/gluteal)], clinically-stable patients were randomized (1 : 1) to PP3M (fixed-dose, 175, 263, 350, or 525 mg eq. deltoid/glute...
Source: International Clinical Psychopharmacology - September 28, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Safety and tolerability of cariprazine in patients with acute exacerbation of schizophrenia: a pooled analysis of four phase II/III randomized, double-blind, placebo-controlled studies
Cariprazine, a potent dopamine D3 and D2 receptor partial agonist antipsychotic with preferential binding to D3 receptors, is Food and Drug Administration approved for treating schizophrenia and manic or mixed episodes of bipolar I disorder. A post-hoc safety/tolerability analysis of data from the four acute trials in the cariprazine schizophrenia clinical development program (NCT00404573; NCT00694707; NCT01104766; NCT01104779) was carried out using the overall safety population (all patients who received ≥1 dose of study drug) and modal daily dose subgroups (1.5–3, 4.5–6, and 9–12 mg/day). Thes...
Source: International Clinical Psychopharmacology - September 28, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Cariprazine specificity profile in the treatment of acute schizophrenia: a meta-analysis and meta-regression of randomized-controlled trials
Cariprazine is a new dopamine D2 and D3 receptor partial agonist antipsychotic. Meta-analytic evidence of efficacy in acute schizophrenia and specific groups of patients is lacking. We carried out a meta-analysis in patients with acute schizophrenia to evaluate the efficacy of cariprazine over placebo and active comparators in overall symptoms, positive and negative symptoms and quality of life. Low and high (≥6 mg/day) doses were tested separately. The possible effect of clinical-demographic modulators was also tested. Four studies (2144 patients) were included. Both high and low cariprazine doses proved superio...
Source: International Clinical Psychopharmacology - September 28, 2017 Category: Psychiatry Tags: Review Articles Source Type: research

Multitarget botanical pharmacotherapy in major depression: a toxic brain hypothesis
A significant number of patients with major depression do not respond optimally to current antidepressant drugs. As depression is likely to be a heterogeneous disorder, it is possible that existing neurotransmitter-based antidepressant drugs do not fully address other pathologies that may exist in certain cases. Biological pathologies related to depression that have been proposed and studied extensively include inflammation and immunology, hypercortisolemia, oxidative stress, and impaired angiogenesis. Such pathologies may induce neurodegeneration, which in turn causes cognitive impairment, a symptom increasingly being rec...
Source: International Clinical Psychopharmacology - September 28, 2017 Category: Psychiatry Tags: Review Articles Source Type: research

The effect of methylphenidate on anxiety and depression symptoms in patients with Asperger syndrome and comorbid attention deficit/hyperactivity disorder
The objective of this study was to assess the response of anxiety and depression symptoms to methylphenidate (MPH) treatment in patients with Asperger syndrome (AS) combined with attention deficit/hyperactivity disorder (ADHD). A group of 12 patients with AS/ADHD, aged 8–18 years, received 12 weeks of MPH treatment. The severities of ADHD, anxiety, and depression symptoms were assessed by means of the ADHD Rating Scale (ADHD-RS), Screen for Child Anxiety Related Emotional Disorders, and the Children’s Depression Inventory. The severity of ADHD and depression symptoms was reduced significantly (P (Source: Intern...
Source: International Clinical Psychopharmacology - August 11, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Effects of vilazodone on suicidal ideation and behavior in adults with major depressive disorder or generalized anxiety disorder: post-hoc analysis of randomized, double-blind, placebo-controlled trials
Treatment-emergent suicidal ideation and behavior are ongoing concerns with antidepressants. Vilazodone, currently approved for the treatment of major depressive disorder (MDD) in adults, has also been evaluated in generalized anxiety disorder (GAD). Post-hoc analyses of vilazodone trials were carried out to examine its effects on suicidal ideation and behavior in adults with MDD or GAD. Data were pooled from vilazodone trials in MDD (four studies) and GAD (three studies). The incidence of suicide-related events was analyzed on the basis of treatment-emergent adverse event reporting and Columbia-Suicide Severity Rating Sca...
Source: International Clinical Psychopharmacology - August 11, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Long-term function and psychosocial outcomes with venlafaxine extended release 75–225 mg/day versus placebo in the PREVENT study
This post-hoc analysis evaluated long-term psychosocial outcomes in patients with recurrent major depressive disorder treated with venlafaxine extended release (ER) 75–225 mg/day or placebo. Patients who responded to 10-week venlafaxine ER 75–300 mg/day treatment and maintained response through a 6-month continuation treatment were assigned randomly to venlafaxine ER or placebo maintenance-phase treatment. Data from responders to acute and continuation venlafaxine ER 75–225 mg/day treatment were analyzed during 12-month maintenance treatment while receiving venlafaxine ER of up to 225...
Source: International Clinical Psychopharmacology - August 11, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Trends and factors associated with antipsychotic use among elderly patients with dementia in Taiwan from 2005 to 2013: a population-based study
This study aimed to examine the trends and factors associated with antipsychotic prescriptions for elderly outpatients with dementia in Taiwan from 2005 to 2013. We assessed the annual prescription patterns of antipsychotic medications among elderly patients attending outpatient visits for dementia between 2005 and 2013 using the National Health Insurance Research Database in Taiwan. We also carried out logistic regression analyses to test the trends and associated factors. We found that any antipsychotic prescriptions for elderly patients making visits for dementia increased slightly, from 25.5 to 26.5%, over the 9-year p...
Source: International Clinical Psychopharmacology - August 11, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Advanced glycation end products among patients maintained on antipsychotics
The aim of this study was to measure advanced glycation end products (AGEs) among participants maintained on antipsychotics using the AGE Reader and to compare them with controls from the general population. Participants maintained on antipsychotics for at least 6 months were recruited from the Psychiatry Department at Rumailah Hospital, Doha, Qatar. Healthy controls were recruited from the primary healthcare centers in Doha, Qatar. AGEs of a total of 86 participants (48 patients and 38 controls) were recorded. Among the group maintained on antipsychotics, women, smokers, and Arabs had significantly higher AGEs levels comp...
Source: International Clinical Psychopharmacology - August 11, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Dopamine D2-receptor affinity of antipsychotics in relation to subjective well-being in patients with a psychotic disorder
Dopamine D2-receptor blockade by antipsychotic medication reduces psychotic symptoms, but may reduce subjective well-being. The current study aims to further explore the relation between dopamine D2-receptor affinity and subjective well-being within a large sample of patients with psychotic disorders. Patients participated in a longitudinal naturalistic cohort study: the Genetic Risk and Outcome of Psychosis (GROUP) study. Three groups of antipsychotic medication were created on the basis of their affinity for the D2-receptor: (i) loose or partial agonistic binding, (ii) moderate binding, and (iii) tight binding. Subjectiv...
Source: International Clinical Psychopharmacology - August 11, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Comparison between long-acting injectable aripiprazole versus paliperidone palmitate in the treatment of schizophrenia: systematic review and indirect treatment comparison
We investigated the relative efficacy and tolerability of aripiprazole once monthly (AOM) versus paliperidone palmitate (PP) for treating schizophrenia. Extensive databases searches on short-term, placebo-controlled, randomized studies of AOM and PP were performed. Indirect treatment comparisons were performed between the two long-acting injectable antipsychotics (LAIAs). The primary efficacy endpoint was the mean change in the Positive and Negative Syndrome Scale total score from baseline between each LAIA and placebo. The effect sizes were mean differences and odds ratio (ORs) with 95% confidence intervals (CIs) for the ...
Source: International Clinical Psychopharmacology - August 11, 2017 Category: Psychiatry Tags: Review Article Source Type: research

Psychotropic drugs prescription in undocumented migrants and indigent natives in Italy
To evaluate psychotropic drug use in undocumented migrants and natives in the same conditions of poverty. We studied drug dispensation by a nongovernmental organization during the year 2014. Drugs were identified according to the Anatomical Chemical Therapeutic classification and their quantity was measured in defined daily doses (DDD). We determined the percentage of patients taking at least one medicine with psychotropic activity in relation to the total number of patients receiving medicines of any class. We also calculated the individual DDD for psychoactive drugs. The percentage of natives receiving this type of medic...
Source: International Clinical Psychopharmacology - August 11, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Use of nalmefene in patients with comorbid borderline personality disorder and alcohol use disorder: a preliminary report
Comorbidity between borderline personality disorder (BPD) and alcohol use disorder (AUD) is high and relevant as alcohol consumption seems to worsen BPD symptomatology. One of the newest treatments for AUD, nalmefene, may be useful to improve BPD symptoms not only indirectly by reducing alcohol consumption but also directly by acting on the opioid system as this system has been related to specific BPD symptoms. This open-label study aimed at evaluating the efficacy of an 8-week nalmefene treatment in reducing alcohol consumption in individuals with BPD and comorbid AUD. A secondary objective was to assess its efficacy in i...
Source: International Clinical Psychopharmacology - June 2, 2017 Category: Psychiatry Tags: Short Communications Source Type: research

Extrapyramidal symptoms in schizophrenia: evidence of blunted cerebral hemodynamics during a planning task
Acute extrapyramidal symptoms (EPS) occur frequently in schizophrenia, mostly caused by antidopaminergic substances. There have been no published reports on the impact of acute EPS on cerebral blood flow (CBF) or related measures. In the following study, we examined schizophrenic patients with and without EPS during a planning task and measurements of CBF velocity. Sixteen patients with chronic schizophrenia and 16 healthy participants performed a planning paradigm during bilateral functional transcranial Doppler sonography of the middle cerebral arteries. Patients with acute EPS showed blunted CBF velocity exclusively dur...
Source: International Clinical Psychopharmacology - June 2, 2017 Category: Psychiatry Tags: Short Communications Source Type: research

Tachycardia in patients treated with clozapine versus antipsychotic long-acting injections
Tachycardia is a known adverse effect during clozapine treatment. However, prevalence reported differs widely between studies and hitherto there are no studies comparing clozapine-treated patients with a similar control group. The present study was carried out to assess the prevalence of tachycardia in patients treated with clozapine and antipsychotic long-acting injections (LAI). Data on heart rate (HR), concomitant medication, and relevant anthropometric and laboratory measurements were collected for all clozapine-treated patients (n=174) in a defined catchment area and compared with data on patients treated with LAI (n=...
Source: International Clinical Psychopharmacology - June 2, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Antipsychotic drug use in nursing home residents with and without dementia: keep an eye on the pro re nata medication
This study aimed to assess antipsychotic drug use in residents with dementia compared with those without dementia. Data were obtained through the cross-sectional ‘inappropriate medication in patients with renal insufficiency in nursing homes’ (IMREN) study including data from 21 nursing homes. Descriptive statistics were used and factors associated with the prescription of antipsychotics were identified by logistic regression. Overall, 57.5% of the 837 residents had a diagnosis of dementia and 47.0% of residents with dementia and 19.5% of those without dementia received antipsychotics. 35.9% of all antipsychoti...
Source: International Clinical Psychopharmacology - June 2, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Utility of functioning in predicting costs of care for patients with mood and anxiety disorders: a prospective cohort study
Development of payment systems for mental health services has been hindered by limited evidence for the utility of diagnosis or symptoms in predicting costs of care. We investigated the utility of functioning information in predicting costs for patients with mood and anxiety disorders. This was a prospective cohort study involving 102 adult patients attending a tertiary referral specialist clinic for mood and anxiety disorders. The main outcome was total costs, calculated by applying unit costs to healthcare use data. After adjusting for covariates, a significant total costs association was yielded for functioning (eβ...
Source: International Clinical Psychopharmacology - June 2, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Silexan in generalized anxiety disorder: investigation of the therapeutic dosage range in a pooled data set
Silexan, a special active substance produced from Lavandula angustifolia, is efficacious in subsyndromal anxiety at a dose of 80 mg/day, but its effective dosage in generalized anxiety disorder (GAD) has yet to be defined. In two double-blind, placebo-controlled trials, daily doses of 10, 40, 80, and 160 mg silexan were administered for 10 weeks. A total of 925 adults with GAD according to Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria and a Hamilton Anxiety Scale (HAMA) total score of at least 18 points were analyzed for efficacy. We assessed the change versus baseline for the HAMA and ...
Source: International Clinical Psychopharmacology - June 2, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Antidepressant effect in older depressed patients: the lessons of two agomelatine trials
The present paper reports in parallel the findings of the two phase III trials that evaluated the efficacy of agomelatine in older depressed patients. It describes how the particular methodological innovations (particularly in relation to patient selection, design and accuracy of diagnosis of depression) introduced in study 2 have improved the quality of recruitment of patients and the assay sensitivity. Study 1 lacked assay sensitivity, and among the many differences with study 2, the inclusion of unexpected mildly ill patients could have inflated the placebo response. The increased demands on investigators in study 2 app...
Source: International Clinical Psychopharmacology - June 2, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Managing interactions between cognitive enhancers and other psychotropics
Polypharmacy is common in psychiatry. Usage of cognitive enhancers is increasing in the psychiatric population. Many clinicians are not familiar with these new psychoactive compounds. This paper reviews the potential drug–drug interactions when these cognitive enhancers are used together with psychotropic drugs and their confounding effects on diagnosis and clinical management. (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - June 2, 2017 Category: Psychiatry Tags: Review Article Source Type: research

Efficacy of clozapine on dopamine supersensitivity psychosis in schizophrenia
Although the effectiveness of clozapine (CLZ) for patients with treatment-resistant schizophrenia (TRS) has been well established, its active mechanism has not been completely clarified. Several clinical studies showed that neuroleptic-induced dopamine supersensitivity psychosis (DSP) could be involved in the etiology of TRS. We preliminarily explored the possible beneficial effect of CLZ for dopamine supersensitivity schizophrenia. The present study is a case series. We followed 15 patients with DSP for about 2.5 years from the introduction of CLZ and compared the prevalence of episodes (particularly, rebound psychosis, t...
Source: International Clinical Psychopharmacology - March 30, 2017 Category: Psychiatry Tags: Short Communication Source Type: research

Indications for and use of long-acting injectable antipsychotics: consideration from an inpatient setting
Studies have examined the differences in sociodemographic/clinical characteristics between patients on long-acting injectable (LAI) versus oral medications. However, most studies did not focus specifically on patients for whom LAIs would clearly be indicated. We performed a chart review of patients with schizophrenia or schizoaffective disorder. Patients were categorized as having an ‘indication for an LAI’ or not on the basis of their adherence history. Patients for whom an LAI was indicated and prescribed on discharge were then compared with similar patients for whom an LAI was not prescribed. Of 305 charts r...
Source: International Clinical Psychopharmacology - March 30, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Clozapine usage increases the incidence of pneumonia compared with risperidone and the general population: a retrospective comparison of clozapine, risperidone, and the general population in a single hospital over 25 months
The aim of this study was to determine whether the incidence of pneumonia in patients taking clozapine was more frequent compared with those taking risperidone or no atypical antipsychotics at all before admission to a tertiary care medical center. This was a retrospective, case-matched study of 465 general medicine patients over a 25 month period from 1 July 2010 to 31 July 2012. Detailed electronic medical records were analyzed to explore the association between the use of two atypical antipsychotics and incidence of pneumonia. Of the 155 patients in the clozapine group, 54 (34.8%) had documented pneumonia compared with ...
Source: International Clinical Psychopharmacology - March 30, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Reduced sexual dysfunction with aripiprazole once-monthly versus paliperidone palmitate: results from QUALIFY
Sexual dysfunction, a common side effect of antipsychotic medications, may be partly caused by dopamine antagonism and elevation of prolactin. In QUALIFY, a randomized study, aripiprazole once-monthly 400 mg (AOM 400), a dopamine D2 receptor partial agonist, showed noninferiority and subsequent superiority versus paliperidone palmitate (PP), a dopamine D2 receptor antagonist, on the Heinrichs–Carpenter Quality-of-Life Scale (QLS) in patients with schizophrenia aged 18–60 years. Sexual dysfunction (Arizona Sexual Experience Scale) and serum prolactin levels were also assessed. Odds for sexual dysfunction ...
Source: International Clinical Psychopharmacology - March 30, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Serum concentrations of psychotropic drugs in neonates as a PROgnOstic Factor for admission to the neonatology ward and withdrawal symptoms: PROOF-1
The aim is to determine whether serum drug concentrations obtained from the neonate’s umbilical cord can be used as a prognostic factor for admission to the neonatology ward and the occurrence of withdrawal symptoms. A retrospective observational monocenter cohort study was carried out among pregnant women using psychotropic drugs and their baby. Binary logistic regression was used for the multivariate analysis. Of the 186 neonates included, 22.6% (n=42) were admitted to the neonatology ward, 6.5% (n=12) because of withdrawal. Among women with therapeutic concentrations of psychotropic medication, 22.0% (n=5) of the ...
Source: International Clinical Psychopharmacology - March 30, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Use of benzodiazepines and related drugs is associated with a risk of stroke among persons with Alzheimer’s disease
In conclusion, BZDR use was associated with an increased risk of stroke among older individuals with AD. (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - March 30, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Clinical factors related to acute electroconvulsive therapy outcome for patients with major depressive disorder
The aim of this study was to explore the significant predictors associated with electroconvulsive therapy (ECT) outcome for patients with major depressive disorder. Major depressive disorder inpatients (N=130) requiring ECT were recruited from a major psychiatric center in South Taiwan. ECT was generally performed for a maximum of 12 sessions. Symptom severity was assessed using the 17-item Hamilton Depression Rating Scale (HAMD-17) and Clinical Global Impression of Severity (CGI-S) before ECT, after every three ECT sessions, and after the last ECT. The generalized estimating equations method was used to analyze the influe...
Source: International Clinical Psychopharmacology - March 30, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Double-blind switch study of vilazodone in the treatment of major depressive disorder
Approximately 40% of patients treated for depression do not respond to a trial of an antidepressant. The aim of the proposed study was to evaluate the efficacy and safety of switching to vilazodone in patients with major depressive disorder who are unresponsive or only partially responsive to a trial of citalopram. Seventy-nine adults with major depressive disorder were enrolled in an open-label study of citalopram (20 mg/day) for 6 weeks. Those still symptomatic after 6-weeks of citalopram were randomly assigned to either a higher dose of citalopram (40 mg/day) or to vilazodone in a double-blind trial for 6 ...
Source: International Clinical Psychopharmacology - March 30, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Predictors of rehospitalization in a naturalistic cohort of patients with bipolar affective disorder
There has only been limited research into the predictors of readmission in bipolar disorder. We carried out a 1-year follow-up of patients discharged from a single mental health unit following admission for treatment of an acute bipolar episode. Of 519 patients followed up for 1 year, 167 (32.2%) were readmitted. There was no association between readmission and any drug regimen. Prescription of antidepressants at discharge was not associated with increased risk of readmission [odds ratio (OR): 0.99, 95% confidence interval (CI): 0.98–1.01]. Among demographic factors, only smoking (OR: 1.75, 95% CI: 1.14–2.75) a...
Source: International Clinical Psychopharmacology - March 30, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

A double-blind, placebo-controlled study of inositol in trichotillomania
Trichotillomania is characterized by repetitive pulling that causes noticeable hair loss. Data on the pharmacological treatment of trichotillomania are limited, with no clear first-line agent. The aim of the current study was to determine the efficacy and tolerability of inositol in adults with trichotillomania. A total of 38 individuals (35 women; mean age: 28.9±11.4) with trichotillomania entered a 10-week, double-blind, placebo-controlled trial to evaluate the safety and efficacy of inositol (dosing ranging from 6 to 18 g/day). Patients were assessed using the Massachusetts General Hospital Hair Pulling Sc...
Source: International Clinical Psychopharmacology - January 27, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Adverse events in children and adolescents treated with quetiapine: an analysis of adverse drug reaction reports from the Danish Medicines Agency database
Quetiapine is a low-affinity dopamine D2 receptor antagonist, approved for the treatment of bipolar disorder and schizophrenia in children and adolescents by the Food and Drug Administration, but not by European Medicine Agency. Although knowledge of adverse drug reactions in children and adolescents is scarce, quetiapine is increasingly being used for youth in Denmark. The aim of this case study is to discuss adverse drug events (ADEs) spontaneously reported to the Danish Medicines Agency on quetiapine used in the pediatric population in relation to adversive drug reactions (ADRs) reported in the European Summary of Produ...
Source: International Clinical Psychopharmacology - January 27, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

The impact of paliperidone palmitate long-acting injection on hospital admissions in a mental health setting
We screened 216 patients in a retrospective observational investigator-initiated study, of whom 45.37% patients (n=98) were retained after the inclusion criteria were applied. These patients had been prescribed paliperidone palmitate long-acting injection (PPLAI) with diagnoses of schizophrenia, schizoaffective disorder and bipolar affective disorder. We investigated whether PPLAI has an effect on the frequency and length of admissions to mental health inpatient units, the number of contacts with Crisis Resolution Home Treatment Teams (CRHTT) and frequency of home visits by the CRHTT per patient, over 6 years, split using ...
Source: International Clinical Psychopharmacology - January 27, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Simvastatin adjunct therapy for negative symptoms of schizophrenia: a randomized double-blind placebo-controlled trial
We investigated the effects of simvastatin adjunctive therapy on the negative symptoms of schizophrenia. In this double-blind trial, inpatients with chronic schizophrenia were clinically stabilized on a constant dose of risperidone for at least 4 weeks before the study and were then randomized to receive risperidone (4–6 mg/day) plus either simvastatin (40 mg/day) (n=33) or placebo (n=33) for 8 weeks. The Positive and Negative Syndrome Scale was used to measure the negative, positive, and general symptoms of schizophrenia at baseline and every 2 weeks. The Hamilton Depression Rating Scale and the Extrap...
Source: International Clinical Psychopharmacology - January 27, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Is cerebrovascular disease a silent condition in patients with chronic schizophrenia-related disorders?
Patients with chronic schizophrenia-related disorders are at a heightened risk of developing cardiovascular disease. The presence and interpretation of cerebral vascular lesions in neuroimaging tests in these patients represents a common clinical challenge. Nevertheless, the literature on cerebrovascular disease in this population is scarce and contradictory. The aim of this study was to analyse the relationship between schizophrenia-related disorders and cerebrovascular morbidity. A case–control study compared cerebrovascular morbidity in a group of patients with schizophrenia-related disorder versus a group of pati...
Source: International Clinical Psychopharmacology - January 27, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Effects of levomilnacipran extended-release on major depressive disorder patients with cognitive impairments: post-hoc analysis of a phase III study
Performance-based cognitive data were collected using the Cognitive Drug Research System in a study of levomilnacipran extended-release (ER) 40–120 mg/day (NCT01034462) in adults with major depressive disorder. These data were analyzed post-hoc to explore the relationship between cognitive measures, depression symptoms (Montgomery–Åsberg Depression Rating Scale, MADRS), and self-reported psychosocial functioning (Sheehan Disability Scale; SDS). Changes from baseline were analyzed in the intent-to-treat population and subgroups with impaired attention, as indicated by baseline Cognitive Drug Researc...
Source: International Clinical Psychopharmacology - January 27, 2017 Category: Psychiatry Tags: Original Articles Source Type: research

Patients on psychotropic medications and herbal supplement combinations: clinical considerations
Populations using herbs and herbal preparations are widespread and growing. As many herbal ingredients exert actions on psychotropic drug targets, psychiatrists should be well informed and aware of potential drug–drug interactions in clinical practice. Reliable and clinically useful information in this area, however, is fragmented, if not deficient. This paper reviewed the clinical aspects of herb–drug interactions, focusing in particular on the monoamine oxidase enzyme and P450 cytochrome enzyme-inhibitory properties of herbs and their potential interference with psychotropic drug actions and clinical judgemen...
Source: International Clinical Psychopharmacology - January 27, 2017 Category: Psychiatry Tags: Review Articles Source Type: research

Lithium and cognition in those with bipolar disorder
Although a percentage of patients report cognitive side-effects when taking lithium, it can be difficult to determine from the literature whether any cognitive changes reflect lithium itself, the lithium serum level, residual mood symptoms, the underlying nature of bipolar disorder, or biological alterations such as hypothyroidism. This review was carried out to synthesize and evaluate relevant literature examining any cognitive impact of lithium in those with bipolar disorder. The effect of lithium in those with bipolar disorder was examined across the cognitive domains of attention, psychomotor speed, processing speed, w...
Source: International Clinical Psychopharmacology - January 27, 2017 Category: Psychiatry Tags: Review Articles Source Type: research

Effect of aripiprazole lauroxil on agitation and hostility in patients with schizophrenia: Erratum
No abstract available (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - December 2, 2016 Category: Psychiatry Tags: Erratum Source Type: research

Pregabalin for generalized anxiety disorder: an updated systematic review and meta-analysis
Generalized anxiety disorder (GAD), characterized by pervasive and highly distressing anxiety and worries, is associated with severe impairment. Although numerous agents from various drug classes are available to treat GAD, as many as 50% of patients have inadequate response, constituting an important medical frontier. In the face of this challenge, new pharmacological alternatives need to be further studied aiming at clinical improvement and better quality of life for patients. To assess the efficacy of pregabalin (PGB) compared with placebo for amelioration of anxiety symptoms in patients with GAD. A systematic literatur...
Source: International Clinical Psychopharmacology - December 2, 2016 Category: Psychiatry Tags: Review Article Source Type: research

Early improvement with pregabalin predicts endpoint response in patients with generalized anxiety disorder: an integrated and predictive data analysis
Generalized anxiety disorder (GAD), a common mental disorder, has several treatment options including pregabalin. Not all patients respond to treatment; quickly determining which patients will respond is an important treatment goal. Patient-level data were pooled from nine phase II and III randomized, double-blind, short-term, placebo-controlled trials of pregabalin for the treatment of GAD. Efficacy outcomes included the change from baseline in the Hamilton Anxiety Scale (HAM-A) total score and psychic and somatic subscales. Predictive modelling assessed baseline characteristics and early clinical responses to determine t...
Source: International Clinical Psychopharmacology - December 2, 2016 Category: Psychiatry Tags: Original Articles Source Type: research

Psychological dependence on antidepressants in patients with panic disorder: a cross-sectional study
This study was carried out in four psychiatric clinics in Tokyo, Japan. Individuals were eligible if they were outpatients aged 18 years or older and fulfilled the diagnostic criteria for panic disorder (ICD-10). Assessments included the Japanese Versions of the Severity of Dependence Scale (SDS), the Self-Report Version of Panic Disorder Severity Scale (PDSS-SR), and the Quick Inventory of Depressive Symptomatology-Self Report. Eighty-four individuals were included; of these, 30 patients (35.7%) showed psychological dependence on antidepressants (i.e. a total score of ≥5 in the SDS). A multiple regression analysis show...
Source: International Clinical Psychopharmacology - December 2, 2016 Category: Psychiatry Tags: Original Articles Source Type: research

Effects of vilazodone on sexual functioning in healthy adults: results from a randomized, double-blind, placebo-controlled, and active-controlled study
The aim of this study is to evaluate the effects of vilazodone on sexual functioning in healthy, sexually active adults and assess the impact of medication nonadherence in this type of trial. Participants were randomized to vilazodone (20 or 40 mg/day), paroxetine (20 mg/day), or placebo for 5 weeks of double-blind treatment. The primary endpoint was change from baseline to day 35 in Change in Sexual Functioning Questionnaire (CSFQ) total score in the intent-to-treat (ITT) population. Post-hoc analyses were carried out in modified intent-to-treat (mITT) populations that excluded participants in the active-tre...
Source: International Clinical Psychopharmacology - December 2, 2016 Category: Psychiatry Tags: Original Articles Source Type: research

Pharmacokinetics and effect on the corrected QT interval of single-dose escitalopram in healthy elderly compared with younger adults
In conclusion, the pharmacokinetics and QT effect of a single dose of escitalopram observed in the elderly without comorbidities and younger adults were generally similar. (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - December 2, 2016 Category: Psychiatry Tags: Original Articles Source Type: research

Long-term use of antipsychotics in community-dwelling dementia patients: prevalence and profile accounting for unobservable time bias because of hospitalization
This study showed that long-term use of AP remained frequent in community-dwelling patients with dementia. It also showed that the prevalence of long-term users almost doubled when hospitalization periods were counted as AP exposure. This underlines the need to consider hospitalization periods when assessing medication exposure in populations with frequent periods of hospitalization. (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - December 2, 2016 Category: Psychiatry Tags: Original Articles Source Type: research

Tolerability of effective high doses of paliperidone palmitate in patients with severe resistant schizophrenia
The aim of the study was to evaluate the effectiveness and tolerability of doses of paliperidone palmitate (PP) of 175 mgEq and over/28 days in patients with severe schizophrenia [Clinical Global Impression-Severity scale (CGI-S)≥5] and their retention in treatment. A 36-month prospective, observational study was carried out of patients with severe schizophrenia who were treated with 175 mg and over every 28 days of PP to achieve clinical stabilization (N=30). Assessment included CGI-S, WHO Disability Assessment Schedule, Camberwell Assessment of Need, and Medication Adherence Report Scale. Laboratory test...
Source: International Clinical Psychopharmacology - December 2, 2016 Category: Psychiatry Tags: Original Articles Source Type: research

Risk excess of mortality and use of antipsychotics: a case–noncase study
In this study, we addressed the potential association of the reported mortality among patients on antipsychotics compared to other drugs from a pharmacovigilance database with the aim of evaluating the drug-induced mortality risk. A database containing 189 441 entries of suspected adverse reactions reported from 1 January 1995 to 31 December 2012 was explored for fatal outcomes. Potential disproportionality was estimated using the reporting odds ratio, proportional reporting ratio, and the χ2-test. Two-hundred fatal outcomes were reported in patients on antipsychotics, which indicated the occurrence of dispropor...
Source: International Clinical Psychopharmacology - December 2, 2016 Category: Psychiatry Tags: Original Articles Source Type: research

Association of the BDNF Val66Met polymorphism with BMI in chronic schizophrenic patients and healthy controls
This study aimed to determine whether there was a relationship between the BDNF Val66Met polymorphism and BMI values in patients with chronic schizophrenia. We compared 308 Han Chinese patients with schizophrenia on long-term antipsychotic medication with 304 healthy normal controls on BDNF polymorphism. Body weight and BMI were measured before breakfast on the day blood samples were taken. The symptomatology of schizophrenia was assessed using the Positive and Negative Syndrome Scale. The results showed that the BDNF Val66Met polymorphism was associated with the BMI value, with genotype having a strong effect on the mean ...
Source: International Clinical Psychopharmacology - September 29, 2016 Category: Psychiatry Tags: Short Communication Source Type: research

Which factors influence onset and latency to treatment in generalized anxiety disorder, panic disorder, and obsessive–compulsive disorder?
Anxiety disorders are common, comorbid, and disabling conditions, often underdiagnosed and under-treated, typically with an early onset, chronic course, and prolonged duration of untreated illness. The present study aimed to explore the influence of sociodemographic and clinical factors in relation to onset and latency to treatment in patients with generalized anxiety disorder (GAD), panic disorder (PD), and obsessive–compulsive disorder (OCD). A total of 157 patients with a Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text Revision (DSM-IV-TR) diagnosis of PD (n=49), GAD (n=68), and OCD (n=40) were...
Source: International Clinical Psychopharmacology - September 29, 2016 Category: Psychiatry Tags: Original Articles Source Type: research

Ziprasidone augmentation for anxious depression
Previously, we found an anxiolytic effect of ziprasidone augmentation to escitalopram (compared with placebo augmentation) in patients with depression in an 8-week, randomized, double-blind, parallel-group, placebo-controlled trial. Here, we carried out a post-hoc analysis, comparing changes in the Hamilton Depression and Anxiety Rating Scales between patients with anxious depression versus nonanxious depression, using a moderator analysis. Hamilton Depression Rating Scales total change scores from baseline and endpoint were not significantly different (interaction term P=0.91) in patients with anxious depression on zipras...
Source: International Clinical Psychopharmacology - September 29, 2016 Category: Psychiatry Tags: Original Articles Source Type: research