Effects of 50 and 100 mg desvenlafaxine versus placebo on sexual function in patients with major depressive disorder: a meta-analysis
The primary objective of this post-hoc analysis was to evaluate the effect of short-term treatment with desvenlafaxine versus placebo on sexual dysfunction (SD), assessed from Arizona Sexual Experiences Scale scores, in adult outpatients with major depressive disorder. Data from three randomized, double-blind, placebo-controlled trials of 50 or 100 mg/day desvenlafaxine for major depressive disorder were pooled. SD status, determined from Arizona Sexual Experiences Scale scores, was assessed at baseline and week 8, last observation carried forward. Subgroup analyses addressed the effects of sex, baseline SD, and ant...
Source: International Clinical Psychopharmacology - October 1, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Vilazodone in patients with generalized anxiety disorder: a double-blind, randomized, placebo-controlled, flexible-dose study
Vilazodone is a selective serotonin reuptake inhibitor and a 5-HT1A receptor partial agonist that is approved for treatment of major depressive disorder in adults in the USA and Mexico. The efficacy, safety, and tolerability of vilazodone for generalized anxiety disorder (GAD) were investigated in a clinical trial (NCT01766401 ClinicalTrials.gov). Participants (18–70 years, inclusive) who met Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision, criteria for GAD were randomized (1 : 1) to placebo or flexible-dose vilazodone (20–40 mg/day) for 8 weeks of double-blind...
Source: International Clinical Psychopharmacology - October 1, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Delayed initiation of clozapine may be related to poor response in treatment-resistant schizophrenia
The aim of this retrospective chart-review study was to investigate the relationship between delayed commencement of clozapine and the level of response in treatment-resistant schizophrenia (TRS). We included 162 patients with schizophrenia who used clozapine. The mean delay until starting clozapine after fulfillment of the TRS criteria was 29 months. The delay was shorter in those who gained benefit from clozapine (P=0.04), those who were treated in a specialized psychosis outpatient unit (P=0.01), and in men (P=0.009), and it correlated with age (P (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - August 5, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Impairment of left ventricular function early in treatment with clozapine: a preliminary study
This preliminary prospective study evaluated cardiac status in 15 treatment-resistant schizophrenia patients (aged 18–55 years) without evidence of cardiovascular disease. Patients underwent clinical assessment, blood tests, ECG, and echocardiography before and during clozapine treatment for 4 weeks as doses increased from 25 to 100 mg/day. Serum concentrations of high-sensitivity C-reactive protein, troponin-I, brain natriuretic peptide, and clozapine+norclozapine were assayed at week 3; ECG and echocardiography were repeated at week 4. At moderate serum drug concentrations (124 ng/ml), the heart rate ...
Source: International Clinical Psychopharmacology - August 5, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Long-acting injectable versus daily oral antipsychotic treatment trials in schizophrenia: pragmatic versus explanatory study designs
Trial design characteristics related to the explanatory : pragmatic spectrum may contribute toward the inconsistent results reported in studies comparing long-acting injectable (LAI) versus daily oral antipsychotic (AP) treatments in schizophrenia. A novel approach examined the hypothesis that a more pragmatic design is important to show the advantages of LAI versus oral APs. A literature search identified comparative studies assessing the clinical efficacy/effectiveness of LAI versus oral APs in more than 100 schizophrenia patients, with 6-month or more duration/follow-up, and published between January 1993 ...
Source: International Clinical Psychopharmacology - August 5, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Pregabalin for the treatment of patients with generalized anxiety disorder with inadequate treatment response to antidepressants and severe depressive symptoms
To evaluate the effectiveness of pregabalin in patients with resistant generalized anxiety disorder (GAD) and severe depressive symptoms, we carried out a post-hoc analysis of a multicenter, prospective, and observational 6-month study. We included patients who were at least 18 years old, fulfilled the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for GAD, showed inadequate responses to previous courses of antidepressant treatment, had Montgomery–Asberg Rating Scale scores of at least 35, had not received pregabalin previously, and were prescribed pregabalin upon entry into this stu...
Source: International Clinical Psychopharmacology - August 5, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Safety and tolerability of vortioxetine (15 and 20 mg) in patients with major depressive disorder: results of an open-label, flexible-dose, 52-week extension study
Vortioxetine is approved for the treatment of adults with major depressive disorder. This open-label extension (OLE) study evaluated the safety and tolerability of vortioxetine in the long-term treatment of major depressive disorder patients, as well as evaluated its effectiveness using measures of depression, anxiety, and overall functioning. This was a 52-week, flexible-dose, OLE study in patients who completed one of three randomized, double-blind, placebo-controlled, 8-week vortioxetine trials. All patients were switched to 10 mg/day vortioxetine for week 1, then adjusted between 15 and 20 mg for the rema...
Source: International Clinical Psychopharmacology - August 5, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Lamotrigine in pregnancy – therapeutic drug monitoring in maternal blood, amniotic fluid, and cord blood
This study is the first to measure and correlate lamotrigine concentrations in maternal blood, amniotic fluid, and umbilical cord blood and account for distribution of the drug between these three compartments. Concentrations of lamotrigine were measured in six mother–infant pairs at the time of delivery. Daily doses of lamotrigine ranged between 200 and 650 mg. Daily doses were correlated with maternal serum and umbilical cord blood concentrations, and serum levels were correlated with levels in amniotic fluid. Lamotrigine levels in serum correlated strongly with the lamotrigine levels in amniotic fluid (r=+0...
Source: International Clinical Psychopharmacology - August 5, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Effects of long-term valproic acid treatment on hematological and biochemical parameters in adolescent psychiatric inpatients: a retrospective naturalistic study
The objective of this study was to determine the long-term hematological and biochemical side effects of valproic acid (VPA) in psychiatric adolescent inpatients. A retrospective naturalistic study design was used. Participants were psychiatric inpatients treated with VPA, alone or in combination with other medications. Electronic medical files were reviewed for changes in hematological and biochemical parameters following a course of VPA treatment. One hundred and four adolescents aged 12–18 (mean 15.76±1.58) years fulfilled the study criteria. The mean blood level and duration of VPA treatment were 65.81&plu...
Source: International Clinical Psychopharmacology - August 5, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Relative absence of studies in bipolar depression
No abstract available (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - August 5, 2015 Category: Psychiatry Tags: Editorial Source Type: research

Treatment of cocaine craving with as-needed nalmefene, a partial κ opioid receptor agonist: first clinical experience
This report describes the case of an abstinent cocaine-addicted patient regularly afflicted with cravings for cocaine. The patient took as-needed nalmefene for 5 months whenever she developed a craving for cocaine. For most of these interventions, the patient reported an abatement of craving and could avoid relapsing into cocaine consumption. This effect may be accounted for by nalmefene acting, other than naltrexone, as a partial agonist of the κ opioid-receptors. Therefore, nalmefene might be a promising new option in the pharmacological repertoire for the treatment of cocaine addiction. (Source: International Clin...
Source: International Clinical Psychopharmacology - June 5, 2015 Category: Psychiatry Tags: Case Report Source Type: research

A retrospective observational study of the effectiveness of paliperidone palmitate on acute inpatient hospitalization rates
This retrospective mirror-image observational study aimed to establish the effects of the long-acting antipsychotic injection paliperidone palmitate (PP) on acute inpatient hospitalization rates. We utilized routinely collected clinical data to compare the number and length of acute patient admissions 1 year before and 1 year after initiation of PP. A single cohort of 66 patients with a diagnosis of schizophrenia and who had received monthly injections of PP for at least 1 year were included in the analysis. The mean number of acute inpatient admissions fell from 0.86 in the year before PP initiation to 0.23 in the followi...
Source: International Clinical Psychopharmacology - June 5, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Construction and validation of the My Medicines and Me Questionnaire for assessment of the self-reported side effects of psychotropic medication
We aimed to construct and assess the psychometric properties of the My Medicines and Me Questionnaire (M3Q), a self-report side-effect questionnaire for mental health patients. Thirty individuals taking a psychotropic medication completed the M3Q side-effect checklist along with the Liverpool University Neuroleptic Side Effect Rating Scale. Thirty healthy comparison individuals also completed the M3Q checklist. Data were analyzed using factorial analysis. Psychometric evaluations including validity and reliability testing were carried out on the questionnaire’s checklist. The original 54-item checklist of the M3Q was...
Source: International Clinical Psychopharmacology - June 5, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Sexual dysfunction during treatment of major depressive disorder with vilazodone, citalopram, or placebo: results from a phase IV clinical trial
Sexual dysfunction commonly occurs with major depressive disorder (MDD). Vilazodone, a selective serotonin reuptake inhibitor and 5-HT1A receptor partial agonist antidepressant approved for the treatment of MDD in adults, was evaluated to determine its effects on sexual function. The primary study was a double-blind, randomized, controlled trial comparing vilazodone 20 and 40 mg/day with placebo; citalopram 40 mg/day was an active control (NCT01473381; http://www.clinicaltrials.gov ). Post-hoc analyses evaluated change from baseline to week 10 on the Changes in Sexual Functioning Questionnaire (CSFQ); no infe...
Source: International Clinical Psychopharmacology - June 5, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Armodafinil in binge eating disorder: a randomized, placebo-controlled trial
This study evaluated the efficacy, tolerability, and safety of armodafinil in the treatment of binge eating disorder (BED). Sixty participants with BED were randomized to receive armodafinil (150–250 mg/day) (N=30) or placebo (N=30) in a 10-week, prospective, parallel-group, double-blind, flexible-dose, single-center trial. In the primary longitudinal analysis, armodafinil and placebo produced similar rates of improvement in binge eating day frequency (the primary outcome measure); however, armodafinil was associated with a statistically significantly higher rate of decrease in binge eating episode frequency. ...
Source: International Clinical Psychopharmacology - June 5, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Long-term use of benzodiazepines and related drugs among community-dwelling individuals with and without Alzheimer’s disease
In this study, 24 966 individuals with AD and 24 985 individuals without AD were included. During the 4-year follow-up, we found that 45% (N=11 312) of individuals with AD and 38% (N=9534) of individuals without AD used BZDRs. The prevalence of long-term (≥180 days) BZDR use was more common among individuals with AD (30%) than individuals without AD (26%). The median durations of the first long-term use periods of BZDRs were 1.5 and 2 years for individuals with and without AD, respectively. Factors associated with long-term BZDR use included female sex, AD, schizophrenia, bipolar disorder, depressio...
Source: International Clinical Psychopharmacology - June 5, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

‘Is it the crime of the century?’: factors for psychiatrists and service users that influence the long-term prescription of hypnosedatives
Given the longstanding controversy about hypnosedative use, we aimed to investigate the attitudes of prescribing psychiatrists and service users towards long-term use of hypnosedative medication, and their perceptions of barriers to evidence-based nonmedication alternatives. Qualitative data from focus groups in Aotearoa/NZ were analysed thematically. A novel research design involved a service user researcher contributing throughout the research design and process. Service users and psychiatrists met to discuss each other’s views, initially separately, and subsequently together. Analysis of the data identified four k...
Source: International Clinical Psychopharmacology - June 5, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Efficacy of treatments for anxiety disorders: a meta-analysis
To our knowledge, no previous meta-analysis has attempted to compare the efficacy of pharmacological, psychological and combined treatments for the three main anxiety disorders (panic disorder, generalized anxiety disorder and social phobia). Pre–post and treated versus control effect sizes (ES) were calculated for all evaluable randomized-controlled studies (n=234), involving 37 333 patients. Medications were associated with a significantly higher average pre–post ES [Cohen’s d=2.02 (1.90–2.15); 28 051 patients] than psychotherapies [1.22 (1.14–1.30); 6992 patients; P (Source: I...
Source: International Clinical Psychopharmacology - June 5, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Caffeine-induced psychiatric manifestations: a review
We present two cases that show the ability of caffeine to induce psychotic and manic symptoms, and we also review the extant literature on caffeine-induced psychiatric manifestations. On the basis of our own and others’ findings, we suggest that caffeine may be related to not only de-novo psychotic or mood symptoms but also to aggravation of pre-existing psychotic or mood disorders. We therefore suggest that caffeine consumption among patients with mood or psychotic symptoms should be assessed carefully in clinical practice as part of routine psychiatric evaluations. (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - June 5, 2015 Category: Psychiatry Tags: Review Article Source Type: research

Lower availability of striatal dopamine transporter in generalized anxiety disorder: a preliminary two-ligand SPECT study
Dopamine and serotonin have been indirectly found to be associated with generalized anxiety disorder (GAD). The aims of this study were to examine the availabilities of the striatal dopamine transporter (DAT) and the midbrain serotonin transporter (SERT) in patients with GAD. 12 patients with GAD and 12 sex-matched, age-matched, and smoking status-matched healthy controls were recruited. The availabilities of DAT and SERT were approximated using single-photon emission computed tomography, with [99mTc]TRODAT-1 and [123I]ADAM as the ligands. There were several missing data for six participants with GAD in the ADAM study beca...
Source: International Clinical Psychopharmacology - April 2, 2015 Category: Psychiatry Tags: Short Communication Source Type: research

A pilot randomized placebo-controlled trial of adjunctive aripiprazole for chronic PTSD in US military Veterans resistant to antidepressant treatment
Many individuals with post-traumatic stress disorder (PTSD) experience persistent symptoms despite pharmacological treatment with antidepressants. Several open-label monotherapy and adjunctive studies have suggested that aripiprazole (a second-generation antipsychotic) may have clinical utility in PTSD. However, there have been no randomized placebo-controlled trials of aripiprazole use for PTSD. We thus conducted a pilot randomized controlled trial of adjunctive aripiprazole versus placebo among Veterans with chronic PTSD serving in the US military since 11 September 2001 to assess the feasibility, safety, tolerability, a...
Source: International Clinical Psychopharmacology - April 2, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Improvement in verbal memory following SSRI augmentation of antipsychotic treatment is associated with changes in the expression of mRNA encoding for the GABA-A receptor and BDNF in PMC of schizophrenic patients
Verbal memory impairment in schizophrenia is associated with abnormalities in gamma-aminobutyric acid (GABA)-ergic and brain-derived neurotrophic factor (BDNF) systems. Recent evidence from animal and clinical studies that adding fluvoxamine to antipsychotics alters the expression of transcripts encoding for the GABA-A receptor and BDNF led us to postulate that fluvoxamine augmentation may improve memory in schizophrenia. To test this, we examined the effect of add-on fluvoxamine on verbal memory and other cognitive functions and related it to the expression of mRNA coding for the GABA-A receptor and BDNF in peripheral mon...
Source: International Clinical Psychopharmacology - April 2, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Switching from risperidone long-acting injectable to paliperidone long-acting injectable or oral antipsychotics: analysis of a Medicaid claims database
This report examines relapse risk following a switch from risperidone long-acting injectable (RLAI) to another long-acting injectable antipsychotic [paliperidone palmitate (PP)] versus a switch to oral antipsychotics (APs). Truven Health’s MarketScan Multistate Medicaid Database compared relapses following switches from RLAI. New user cohorts for these two groups were created on the basis of first incidence of exposure to the ‘switched to’ drug. Groups were balanced using 1:1 propensity score matching. Time-to-event analysis assessed schizophrenia-related hospital/emergency department visits. A total of 1...
Source: International Clinical Psychopharmacology - April 2, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Efficacy and safety of valproic acid versus haloperidol in patients with acute agitation: results of a randomized, double-blind, parallel-group trial
The objective of this study was to compare the efficacy of valproate versus haloperidol in decreasing the agitation level in affected patients in the emergency department. We assigned 80 acutely agitated patients to receive either intravenous sodium valproate (20 mg/kg) or intramuscular haloperidol (5 mg/1 ml). Agitation was measured at baseline and 30 min after the first injection using the Agitation–Calmness Evaluation Scale (ACES), the Positive and Negative Syndrome Scale-Excited Component subscale, and the Agitated Behavior Scale. For 80 patients treated with sodium valproate, the mean...
Source: International Clinical Psychopharmacology - April 2, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Functional impairment in patients with major depression in clinical remission: results from the VIVAL-D-Rem, a nationwide, naturalistic, cross-sectional survey
In recent years, the standard for successful treatment of major depression has switched from response to remission; however, little is known about patients who have achieved remission, but still have some residual symptoms and whether they regain previous levels of functioning. In a large, nationwide, cross-sectional, naturalistic survey (VIVAL-D) of 907 patients with major depression treated with a new course of an antidepressant in 41 Italian community psychiatric centers, patients with a Hamilton Rating Scale for Depression, 17-item version (HAM-D17) score up to 14 were selected (n=499). Of these, 169 were considered to...
Source: International Clinical Psychopharmacology - April 2, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Treating mood disorders in patients with a history of intestinal surgery: a systematic review
Bariatric surgery is increasingly being performed, with the intended benefits of significant and durable weight loss. Radical surgical resection can result in short bowel syndrome (SBS), a rare and devastating condition. Psychological distress is common in these patients. Relevant articles were identified by searching Pubmed and EMBASE databases with the following keywords: ‘Bariatrics’[Mesh] OR ‘Short Bowel Syndrome’ AND ‘Antidepressive Agents’ OR ‘Psychotropic Drugs’[Mesh]. One in-vitro study, four clinical studies and six relevant case reports were identified. Most clinica...
Source: International Clinical Psychopharmacology - April 2, 2015 Category: Psychiatry Tags: Review Article Source Type: research

Successful treatment of hydroxyzine and dexclorfeniramine maleate in combination with electroconvulsive therapy in a neuroleptic malignant catatonia: a case report
Malign neuroleptic syndrome is a potentially life-threatening condition that is normally treated with electroconvulsive therapy (ECT). In this case report, we discuss a severely agitated and catatonic bipolar I patient who developed a neuroleptic malignant syndrome and did not improve with benzodiazepines and ECT. On the basis of anecdotal reports of the positive effects of antihistamines in psychosis and ECT, we treated our case with a combination of two antihistamines, hydroxyzine and dexclorfeniramine maleate, and ECT, which improved the clinical picture to the point of clinical remission. (Source: International Clinica...
Source: International Clinical Psychopharmacology - January 30, 2015 Category: Psychiatry Tags: Case Report Source Type: research

Clozapine-associated neutropenia and agranulocytosis in Argentina (2007–2012)
The risks of severe leukopenia and agranulocytosis have varied over time and among geographical regions and cultures, with little information available on South American populations. Accordingly, we reviewed and analyzed data from a 6-year experience monitored by an Argentine national registry to which reporting of adverse events reports is required. We analyzed data for 2007–2012 from the pharmacovigilance program of the Argentine drug-regulatory agency (ANMAT) using standard bivariate and multivariate statistical methods and survival analysis. We identified 378 cases of adverse hematological events over 6 years amo...
Source: International Clinical Psychopharmacology - January 30, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Prolactin variations during risperidone therapy in a sample of drug-naive children and adolescents
This study suggests that the increase in serum PRL in patients treated with risperidone may be linked not only to the drug and its dosage but also to several risk factors such as sex, pubertal stage, psychiatric disease, and autoimmune disorders. (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - January 30, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Sex-specific factors for bone density in patients with schizophrenia
This study aims to examine specific risk factors of low BMD in different sexes. Men (n=80) and women (n=115) with schizophrenia, similar in demographic and clinical characteristics, were enrolled in three centers. Clinical and laboratory variables (including blood levels of prolactin, sex and thyroid hormones, cortisol, calcium, and alkaline phosphatase) were collected. BMD was measured using a dual-energy X-ray absorptiometer. Men had lower BMD than women. Predictors for BMD in men included hyperprolactinemia (B=−0.821, P=0.009), body weight (B=0.024, P=0.046), and Global Assessment of Functioning score (B=0.027, P=...
Source: International Clinical Psychopharmacology - January 30, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Cognitive differences in schizophrenia on long-term treatments with clozapine, risperidone and typical antipsychotics
This study examined the effect of long-term treatment with APDs on cognition in schizophrenia. Cognitive function was assessed in 418 patients with schizophrenia on long-term treatment with APDs (215 on clozapine, 91 on risperidone and 112 on typical APDs) and 159 healthy controls using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Schizophrenia symptomatology was assessed using the Positive and Negative Syndrome Scale (PANSS). We found that cognitive test scores were significantly lower in all patients compared with the healthy controls on almost all of the total and subscores of RBANS (a...
Source: International Clinical Psychopharmacology - January 30, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Pharmacogenetics of quetiapine in healthy volunteers: association with pharmacokinetics, pharmacodynamics, and adverse effects
Quetiapine is an atypical antipsychotic used for treatment of schizophrenia. Variability in response to this drug may be associated with pharmacogenetics. The aim of this study was to identify genetic markers related to the pharmacokinetics, pharmacodynamics, and adverse effects of quetiapine. The study population comprised 79 healthy volunteers from two bioequivalence trials who were genotyped to identify polymorphisms in genes encoding enzymes, receptors, and transporters. Quetiapine plasma levels were quantified using high-performance liquid chromatography/mass spectrometry. Prolactin plasma levels were detected by indi...
Source: International Clinical Psychopharmacology - January 30, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Evaluating the efficacy of vilazodone in achieving remission in patients with major depressive disorder: post-hoc analyses of a phase IV trial
The aim of this study was to evaluate the efficacy of vilazodone using different definitions of remission. Post-hoc analyses were carried out using data from an 8-week, multicenter, randomized, double-blind, placebo-controlled trial of vilazodone 40 mg/day in adults with major depressive disorder (NCT01473394). The primary efficacy endpoint was a mean change in the Montgomery–Åsberg Depression Rating Scale (MADRS) total score; additional measures included the Clinical Global Impressions-Severity (CGI-S) and Hamilton Rating Scale for Anxiety (HAMA) scores. In addition to treatment response (MADRS≥50% i...
Source: International Clinical Psychopharmacology - January 30, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Efficacy and safety of vilazodone 20 and 40 mg in major depressive disorder: a randomized, double-blind, placebo-controlled trial
Vilazodone is a selective serotonin reuptake inhibitor and 5-HT1A partial agonist approved for major depressive disorder (MDD) treatment in adults. This was a 10-week, multicenter, double-blind, placebo-controlled and active-controlled, fixed-dose trial (NCT01473381). Adult patients with MDD (Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision criteria) were randomized 1 : 1 : 1 : 1 to vilazodone 20 or 40 mg/day, citalopram 40 mg/day, or placebo. Primary efficacy: Montgomery–Åsberg Depression Rating Scale (MADRS); secondary effica...
Source: International Clinical Psychopharmacology - January 30, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Predictors of placebo response in bipolar depression
The aim of this work is to investigate placebo response rates in placebo-controlled randomized clinical trials (RCTs) of pharmacological therapy in bipolar depression (BPD) and to identify predictors of placebo response and clinical trial outcome in BPD. Medline/PubMed publication databases were searched for RCTs of oral drugs used as monotherapy for the treatment of BPD, published between January 1980 and September 2013. Data extracted from 12 manuscripts and one poster, representing a total of 17 clinical trials, were pooled. Pooled response rates for drug and placebo were 55.1 and 39.2%, corresponding to a risk ratio fo...
Source: International Clinical Psychopharmacology - January 30, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Quetiapine augmentation for depression: dosing pattern in routine practice
This study investigated the dosing patterns of quetiapine augmentation (QA) for major depressive disorder (MDD) in routine practice. Between 1 January 2009 and 31 May 2013, patients with a diagnosis of MDD who were receiving QA in conjunction with an ongoing antidepressant were recruited into this study. The electronic medical records and clinical data for a total of 977 patients were reviewed up to a year. Almost half the patients maintained QA treatment for more than 3 months. The mean duration of QA was ∼6 months, and the mean initial and maintenance doses were 23.6 and 40.7 mg/day, respectively (range=12.5&n...
Source: International Clinical Psychopharmacology - January 1, 2015 Category: Psychiatry Tags: Short Communication Source Type: research

Treatment of depressive symptoms in patients with schizophrenia: a randomized, open-label, parallel-group, flexible-dose subgroup analysis of patients treated with extended-release quetiapine fumarate or risperidone
The present analysis assessed the efficacy of extended-release quetiapine fumarate (quetiapine XR) versus risperidone in patients with schizophrenia and depressive symptoms [Hamilton Depression Rating Scale (HAM-D) score≥20 and a HAM-D item 1 score≥2]. This was a subanalysis of patients with schizophrenia from a randomized, open-label, parallel-group, flexible-dose study (NCT00640562) that also enrolled patients with schizoaffective disorder. The primary endpoint of this noninferiority study was change from baseline to week 12 in Calgary Depression Scale for Schizophrenia score (per protocol population). Overall, 114...
Source: International Clinical Psychopharmacology - January 1, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Adjunctive lisdexamfetamine in bipolar depression: a preliminary randomized, placebo-controlled trial
This study evaluated the efficacy and tolerability of lisdexamfetamine (LDX) in the treatment of bipolar depression. Twenty-five outpatients with bipolar I or II disorder and syndromal depression despite at least 4 weeks of stable mood stabilizer and/or antipsychotic therapy were randomized to receive LDX (N=11) or placebo (N=14) in an 8-week, prospective, parallel-group, double-blind study. In the primary longitudinal analysis, LDX and placebo produced similar rates of improvement in depressive symptoms as assessed by the Montgomery–Asberg Depression Scale. However, LDX was associated with a statistically significan...
Source: International Clinical Psychopharmacology - January 1, 2015 Category: Psychiatry Tags: Original Articles Source Type: research

Lithium in drinking water and suicide prevention: a review of the evidence
Suicide is a serious public health problem worldwide, and many nations are committed to developing prevention programmes to reduce the incidence of suicide. To date, several strategies have been proposed for suicide prevention, both at the population and at the individual level, some of which may be pharmacological. In particular, a substantial amount of data show that lithium significantly reduces mortality in patients with mood disorders. Initiating from this evidence, some recent studies have investigated whether a relationship might exist between levels of lithium in drinking water and mortality rates for suicide in th...
Source: International Clinical Psychopharmacology - January 1, 2015 Category: Psychiatry Tags: Review Article Source Type: research

Quetiapine augmentation for depression: dosing pattern in routine practice
This study investigated the dosing patterns of quetiapine augmentation (QA) for major depressive disorder (MDD) in routine practice. Between 1 January 2009 and 31 May 2013, patients with a diagnosis of MDD who were receiving QA in conjunction with an ongoing antidepressant were recruited into this study. The electronic medical records and clinical data for a total of 977 patients were reviewed up to a year. Almost half the patients maintained QA treatment for more than 3 months. The mean duration of QA was ∼6 months, and the mean initial and maintenance doses were 23.6 and 40.7 mg/day, respectively (range=12.5&n...
Source: International Clinical Psychopharmacology - December 5, 2014 Category: Psychiatry Tags: Short Communication Source Type: research

Safety and drinking outcomes among patients with comorbid alcohol dependence and borderline personality disorder treated with high-dose baclofen: a comparative cohort study
In France, the off-label use of high-dose baclofen (HDB) for alcohol dependence is spreading. HDB induces frequent neuropsychiatric adverse events (AEs). Borderline personality disorder (BPD) is a major axis-two psychiatric disorder that exposes to frequent comorbid alcohol dependence and increased risky behaviors. We investigated the drinking and safety outcomes of patients with BPD treated with HDB for comorbid alcohol dependence. In a prospective cohort of 204 patients with alcohol dependence treated by HDB, 23 patients fulfilled the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. criteria for BPD. We pai...
Source: International Clinical Psychopharmacology - December 5, 2014 Category: Psychiatry Tags: Original Articles Source Type: research

Clomipramine demethylation rate is important on the outcome of obsessive–compulsive disorder treatment
The aim of this study was to investigate the influence of demethylation rate on the outcome of obsessive–compulsive disorder patients treated with clomipramine. Eighteen patients meeting the DSM-IV criteria for obsessive–compulsive disorder received 150–300 mg of clomipramine daily in a single-blind design for 12 weeks. The patients were evaluated with the Clinical Global Impression scale and the Yale–Brown Obsessive–Compulsive Scale (YBOCS). Clinical assessment and serum measurements of clomipramine and desmethylclomipramine were carried out at baseline and after 3, 6, 8, 10, and 12 we...
Source: International Clinical Psychopharmacology - December 5, 2014 Category: Psychiatry Tags: Original Articles Source Type: research

Lasting treatment effects in a postmarketing surveillance study of prolonged-release melatonin
We report data from a postmarketing surveillance study in Germany on the effects of 3 weeks of treatment with PRM on sleep in patients with insomnia during treatment and at early (1–2 days) and late (around 2 weeks) withdrawal. In total, 653 patients (597 evaluable) were recruited at 204 sites (mean age 62.7 years, 68% previously treated with hypnotics, 65% women). With PRM treatment, the mean sleep quality (on a scale of 1–5 on which 1 is very good and 5 is very bad) improved from 4.2 to 2.6 and morning alertness improved from 4.0 to 2.5. The improvements persisted over the post-treatment observation period. R...
Source: International Clinical Psychopharmacology - December 5, 2014 Category: Psychiatry Tags: Original Articles Source Type: research

Factors characterizing access and latency to first pharmacological treatment in Italian patients with schizophrenia, mood, and anxiety spectrum disorders
Latency to first pharmacological treatment [duration of untreated illness (DUI)] in psychiatric disorders can be measured in years, with differences across diagnostic areas and relevant consequences in terms of socio-occupational functioning and outcome. Within the psychopathological onset of a specific disorder, many factors influence access and latency to first pharmacotherapy and the present study aimed to investigate such factors, through an ad-hoc developed questionnaire, in a sample of 538 patients with diagnoses of schizophrenia-spectrum disorder (SZ), mood disorder (MD), and anxiety disorder (AD). Patients with SZs...
Source: International Clinical Psychopharmacology - December 5, 2014 Category: Psychiatry Tags: Original Articles Source Type: research

Increased lean body mass as an early indicator of olanzapine-induced weight gain in healthy men
One of the primary limitations of many psychiatric medications is weight gain, the mechanism of which remains to be fully elucidated. We conducted a 2-week double-blind placebo-controlled study on weight gain with olanzapine, which is frequently but unpredictably associated with this side effect, to address the possible mechanisms of weight gain independent of changes in the psychiatric condition for which it is prescribed. Healthy male volunteers were randomly assigned to olanzapine (5 mg/day for 7 days, then 10 mg/day for 7 days) or a matching placebo. Of the 24 participants, 19 completed the study (olanzap...
Source: International Clinical Psychopharmacology - December 5, 2014 Category: Psychiatry Tags: Original Articles Source Type: research

Treatment of depressive symptoms in patients with schizophrenia: a randomized, open-label, parallel-group, flexible-dose subgroup analysis of patients treated with extended-release quetiapine fumarate or risperidone
The present analysis assessed the efficacy of extended-release quetiapine fumarate (quetiapine XR) versus risperidone in patients with schizophrenia and depressive symptoms [Hamilton Depression Rating Scale (HAM-D) score≥20 and a HAM-D item 1 score≥2]. This was a subanalysis of patients with schizophrenia from a randomized, open-label, parallel-group, flexible-dose study (NCT00640562) that also enrolled patients with schizoaffective disorder. The primary endpoint of this noninferiority study was change from baseline to week 12 in Calgary Depression Scale for Schizophrenia score (per protocol population). Overall, 114...
Source: International Clinical Psychopharmacology - December 5, 2014 Category: Psychiatry Tags: Original Articles Source Type: research

Adjunctive lisdexamfetamine in bipolar depression: a preliminary randomized, placebo-controlled trial
This study evaluated the efficacy and tolerability of lisdexamfetamine (LDX) in the treatment of bipolar depression. Twenty-five outpatients with bipolar I or II disorder and syndromal depression despite at least 4 weeks of stable mood stabilizer and/or antipsychotic therapy were randomized to receive LDX (N=11) or placebo (N=14) in an 8-week, prospective, parallel-group, double-blind study. In the primary longitudinal analysis, LDX and placebo produced similar rates of improvement in depressive symptoms as assessed by the Montgomery–Asberg Depression Scale. However, LDX was associated with a statistically significan...
Source: International Clinical Psychopharmacology - December 5, 2014 Category: Psychiatry Tags: Original Articles Source Type: research

Lithium in drinking water and suicide prevention: a review of the evidence
Suicide is a serious public health problem worldwide, and many nations are committed to developing prevention programmes to reduce the incidence of suicide. To date, several strategies have been proposed for suicide prevention, both at the population and at the individual level, some of which may be pharmacological. In particular, a substantial amount of data show that lithium significantly reduces mortality in patients with mood disorders. Initiating from this evidence, some recent studies have investigated whether a relationship might exist between levels of lithium in drinking water and mortality rates for suicide in th...
Source: International Clinical Psychopharmacology - December 5, 2014 Category: Psychiatry Tags: Review Article Source Type: research

Efficacy of vilazodone on anxiety symptoms in patients with major depressive disorder
Anxiety symptoms are prevalent in patients with major depressive disorder. A post-hoc analysis of two phase III trials was conducted to evaluate the efficacy of vilazodone on depression-related anxiety. Using the 17-item Hamilton Depression Rating Scale (HAMD17) Anxiety/Somatization subscale, patients were classified as anxious or nonanxious. Improvements in depressive symptoms were based on least squares mean changes in HAMD17 and Montgomery–Asberg Depression Rating Scale total scores. Anxiety symptoms in the anxious subgroup were evaluated using Hamilton Anxiety Rating Scale (HAMA) total and subscale (Psychic Anxie...
Source: International Clinical Psychopharmacology - October 4, 2014 Category: Psychiatry Tags: Original Articles Source Type: research

Ondansetron or placebo in the augmentation of fluvoxamine response over 8 weeks in obsessive–compulsive disorder
The aim of this study was to investigate the efficacy and safety of ondansetron as an augmentative agent to fluvoxamine in the treatment of patients with obsessive–compulsive disorder (OCD). Forty-six men and women, aged 18–60 years, who fulfilled the diagnostic criteria of OCD on the basis of the DSM-IV-TR and had a Yale–Brown Obsessive Compulsive Scale (Y-BOCS) score of at least 21 were recruited into the study. The patients randomly received either ondansetron (8 mg/day) or placebo for 8 weeks. All patients received fluvoxamine (100 mg/day) for the first 4 weeks, followed by 200 mg...
Source: International Clinical Psychopharmacology - October 4, 2014 Category: Psychiatry Tags: Original Articles Source Type: research