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  Subjects -> PHARMACY AND PHARMACOLOGY (Total: 575 journals)
Showing 401 - 253 of 253 Journals sorted alphabetically
Microbial Drug Resistance     Hybrid Journal   (Followers: 3)
Molecular Informatics     Hybrid Journal   (Followers: 5)
Molecular Pharmacology     Hybrid Journal   (Followers: 2)
Molekul     Open Access  
Natural Product Communications     Open Access  
Nature Reviews Drug Discovery     Full-text available via subscription   (Followers: 311)
Naunyn-Schmiedeberg's Archives of Pharmacology     Hybrid Journal  
NeuroMolecular Medicine     Hybrid Journal  
Neuropharmacology     Hybrid Journal   (Followers: 5)
Neuropsychopharmacology     Hybrid Journal   (Followers: 17)
Neuropsychopharmacology Reports     Open Access  
Nigerian Journal of Natural Products and Medicine     Full-text available via subscription  
OA Drug Design & Delivery     Open Access  
OA Medical Hypothesis     Open Access  
Obesity Facts     Open Access   (Followers: 8)
Open Pharmacoeconomics & Health Economics Journal     Open Access   (Followers: 1)
Open Pharmacology Journal     Open Access  
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Orbital - The Electronic Journal of Chemistry     Open Access   (Followers: 1)
Oriental Pharmacy and Experimental Medicine     Partially Free   (Followers: 2)
Pain and Therapy     Open Access   (Followers: 3)
Particulate Science and Technology: An International Journal     Hybrid Journal   (Followers: 1)
PDA Journal of Pharmaceutical Science and Technology     Full-text available via subscription   (Followers: 33)
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Pharmacon : Jurnal Farmasi Indonesia     Open Access  
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Redox Report     Open Access  
Regulatory Mechanisms in Biosystems     Open Access   (Followers: 1)
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Research in Social and Administrative Pharmacy     Hybrid Journal   (Followers: 3)
Research Journal of Pharmacognosy     Open Access  
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Revista Colombiana de Ciencias Químico-Farmacéuticas     Open Access  
Revista Cubana de Plantas Medicinales     Open Access   (Followers: 1)
Revista de Ciências Farmacêuticas Básica e Aplicada     Open Access  
Revista Mexicana de Ciencias Farmaceuticas     Open Access  
Revue de Médecine et de Pharmacie     Full-text available via subscription  
Safety and Risk of Pharmacotherapy     Open Access   (Followers: 1)
Saudi Pharmaceutical Journal     Open Access  
Scandinavian Journal of Clinical and Laboratory Investigation     Hybrid Journal   (Followers: 7)
Scientia Pharmaceutica     Open Access  
Seminars in Hematology     Hybrid Journal   (Followers: 12)
Seminars in Oncology Nursing     Full-text available via subscription   (Followers: 10)
Separation Science plus (SSC plus)     Hybrid Journal  
Side Effects of Drugs Annual     Full-text available via subscription   (Followers: 2)
Skin Pharmacology and Physiology     Full-text available via subscription   (Followers: 6)
Substance Abuse : Research and Treatment     Open Access   (Followers: 5)
Suchttherapie     Hybrid Journal   (Followers: 1)
Sustainable Chemistry and Pharmacy     Full-text available via subscription   (Followers: 1)
Synfacts     Hybrid Journal   (Followers: 5)
SynOpen     Open Access  
The Botulinum J.     Hybrid Journal  
The Brown University Psychopharmacology Update     Hybrid Journal   (Followers: 2)
The Medical Letter     Full-text available via subscription   (Followers: 18)
The Pink Sheet     Full-text available via subscription   (Followers: 12)
The Pink Sheet Daily     Full-text available via subscription   (Followers: 4)
Therapeutic Advances in Drug Safety     Open Access   (Followers: 3)
Therapeutic Advances in Psychopharmacology     Open Access   (Followers: 4)
Therapeutic Advances in Vaccines     Hybrid Journal   (Followers: 1)
Therapeutic Drug Monitoring     Hybrid Journal   (Followers: 3)
Therapeutic Innovation & Regulatory Science     Hybrid Journal   (Followers: 7)
Thérapie     Full-text available via subscription   (Followers: 1)
TheScientist     Free   (Followers: 5)
Toxicological & Environmental Chemistry     Hybrid Journal   (Followers: 2)
Toxicological Research     Hybrid Journal  
Toxicological Sciences     Hybrid Journal   (Followers: 11)
Toxicology     Hybrid Journal   (Followers: 18)
Toxicology and Applied Pharmacology     Hybrid Journal   (Followers: 24)
Toxicology and Industrial Health     Hybrid Journal   (Followers: 6)
Toxicology in Vitro     Hybrid Journal   (Followers: 11)
Toxicology International     Full-text available via subscription   (Followers: 5)
Toxicology Letters     Hybrid Journal   (Followers: 15)
Toxicology Mechanisms and Methods     Hybrid Journal   (Followers: 7)
Toxicology Research     Partially Free   (Followers: 8)
Toxicon     Hybrid Journal   (Followers: 5)
Toxicon : X     Open Access  
Toxin Reviews     Hybrid Journal  
Translational Psychiatry     Open Access   (Followers: 14)
Trends in Peptide and Protein Sciences     Open Access  
Trends in Pharmacological Sciences     Full-text available via subscription   (Followers: 19)
Tropical Journal of Pharmaceutical Research     Open Access  
Ukrainian Biopharmaceutical Journal     Open Access  
Vascular Pharmacology     Hybrid Journal   (Followers: 2)
World Mycotoxin Journal     Hybrid Journal   (Followers: 3)
Yakugaku Zasshi     Open Access   (Followers: 1)
Zeitschrift für Phytotherapie     Hybrid Journal   (Followers: 1)
Актуальні питання фармацевтичної та медичної науки та практики     Open Access  
Фармацевтичний часопис     Open Access  

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Therapeutic Advances in Psychopharmacology
Number of Followers: 4  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2045-1253 - ISSN (Online) 2045-1261
Published by Sage Publications Homepage  [1174 journals]
  • Duration of prior psychotic illness and clozapine response: a
           retrospective observational study using electronic health records

    • Authors: Rowena Jones, Rachel Upthegrove, Malcolm J. Price, Megan Pritchard, Joht Singh Chandan, Sophie Legge, James H. MacCabe
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Background:Clozapine is the gold-standard medication for treatment-resistant schizophrenia (TRS) yet its initiation is often delayed.Objective:To examine whether earlier initiation of clozapine in TRS is associated with lower Clinical Global Impression – Severity (CGI-S) scores at 2 years.Methods:This was a retrospective cohort study from electronic health records of patients with first adequate trial of clozapine at the South London and Maudsley mental health service between 1 January 2007 and 31 December 2016. Dates of illness onset and clozapine commencement were manually extracted from anonymised case notes. CGI-S scores were rated blind to illness duration. Ordinal logistic regression was used to describe the association between illness duration at baseline and CGI-S outcome score at 2 years, following adjustment for CGI-S start score and other key covariates.Results:Among the 401 patients included, there was an association between illness duration and CGI-S outcome score with a 4% increase in the odds of a higher (worse) outcome CGI-S score per year of illness [adjusted odds ratio (AOR) = 1.04; 95% confidence interval (CI): 1.01–1.06]. The association between illness duration and clozapine response was most marked at less than 4 years illness duration. There were too few clozapine initiations within the first 2 years of illness to draw any conclusions about early clozapine initiation.Conclusion:Initiation of clozapine within 2–4 years of psychotic illness onset offers the best outcome for TRS, but the advantage, if any, of earlier initiation is unclear from these data.
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-06-20T01:49:47Z
      DOI: 10.1177/20451253221103353
      Issue No: Vol. 12 (2022)
       
  • Estimation of cardiac QTc intervals in people prescribed antipsychotics: a
           comparison of correction factors

    • Authors: Teodora Andric, Karl Winckel, Timothy David Tanzer, Samantha Hollingworth, Lesley Smith, Katherine Isoardi, Olivier Tan, Dan Siskind
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Background:A prolonged electrocardiogram (ECG) QT interval is associated with cardiac events and increased mortality. Antipsychotics can prolong the QT interval. The QT interval requires correction (QTc) for heart rate using a formula or QT-nomogram. The QT and QTc can be calculated automatically by the ECG machine or manually; however, machine-measured QT(c) intervals may be inaccurate.Objective:We aimed to investigate the mean QTc and proportion of prolonged QTc intervals in people taking antipsychotic medicines.Methods:We conducted an observational retrospective chart review and data analysis of all consecutive patients taking antipsychotics, with an ECG record, admitted to the psychiatric unit of a large tertiary hospital in Brisbane, Australia, between 1 January 2017 and 30 January 2019. We investigated the mean QTc of people taking antipsychotics to determine differences using (a) machine versus manual QT interval measurement and (b) QTc correction formulae (Bazett, Fridericia, Framingham, Hodges and Rautaharju) and the QT-nomogram. We also determined the number of people with a prolonged QTc using different methods and compared rates of prolonged QTc with antipsychotic monotherapy and polypharmacy.Results:Of 920 included people, the mean (±SD) machine-measured, Bazett-corrected QT interval (recorded from the ECG) was 435 ms (±27), significantly longer (p 
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-06-17T06:17:33Z
      DOI: 10.1177/20451253221104947
      Issue No: Vol. 12 (2022)
       
  • Clozapine blood level assessment using a point-of-care device: feasibility
           and reliability

    • Authors: Shiri Kamhi-Nesher, Sharon Taub, Shikma Halimi, Maria Frenkel, Mahmud Azam, Gil Bormant, Helena Isakov, Dikla Radzinsky, Abraham Weizman, Amir Krivoy
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Background:Therapeutic drug monitoring (TDM) is useful to assess clozapine adherence and optimize treatment. However, analysis of venous blood levels by liquid chromatography tandem mass spectrometry (LC-MS/MS) is often logistically complicated and process time is prolonged.Objective:To assess the feasibility and reliability of a new point-of-care device, (MyCare™ Insite), using capillary blood for clozapine therapeutic monitoring.Methods:Matched venous and capillary blood samples were collected from patients treated with clozapine on a stable dose. Samples were analyzed by LC-MS/MS and MyCare Insite Clozapine Test. Clozapine plasma levels were compared between methods using linear regression model. Both patients and treatment team completed questionnaires about the feasibility of blood sampling.Results:Of the total sample (44 patients, 61% males, mean age 43 ± 12 years), mean daily clozapine dose was 293 ± 134 mg/day. Linear regression model demonstrated high correlation with R2 = 0.83 (p 
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-06-14T08:57:27Z
      DOI: 10.1177/20451253221094435
      Issue No: Vol. 12 (2022)
       
  • Treatment strategies for clozapine-induced hypotension: a systematic
           review

    • Authors: Timothy David Tanzer, Thomas Brouard, Samuel Dal Pra, Nicola Warren, Michael Barras, Steve Kisely, Emily Brooks, Dan Siskind
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Background:Clozapine is the most effective medication for treatment–refractory schizophrenia but is associated with significant adverse drug effects, including hypotension and dizziness, which have a negative impact on quality of life and treatment compliance. Available evidence for the management of clozapine-induced hypotension is scant.Objectives:Due to limited guidance on the safety and efficacy of pharmacological treatments for clozapine-induced hypotension, we set out to systematically review and assess the evidence for the management of clozapine-induced hypotension and provide guidance to clinicians, patients, and carers.Design:We undertook a systematic review of the safety and efficacy of interventions for clozapine-induced hypotension given the limited available evidence.Data Sources and Methods:PubMed, Embase, PsycINFO, CINAHL, and the Cochrane trial Registry were searched from inception to November 2021 for literature on the treatment strategies for clozapine-induced hypotension and dizziness using a PROSPERO pre-registered search strategy. For orthostatic hypotension, we developed a management framework to assist in the choice of intervention.Results:We identified nine case studies and four case series describing interventions in 15 patients. Hypotension interventions included temporary clozapine dose reduction, non-pharmacological treatments, and pharmacological treatments. Midodrine, fludrocortisone, moclobemide and Bovril® combination, and etilefrine were associated with improvement in symptoms or reduction in orthostatic hypotension. Angiotensin II, arginine vasopressin, and noradrenaline successfully restored and maintained mean arterial pressure in critical care situations. A paradoxical reaction of severe hypotension was reported with adrenaline use.Conclusion:Orthostatic hypotension is a common side effect during clozapine titration. Following an assessment of the titration schedule, salt and fluid intake, and review of hypertensive and nonselective α1-adrenergic agents, first-line treatment should be a temporary reduction in clozapine dose or non-pharmacological interventions. If orthostatic hypotension persists, fludrocortisone should be trialled with monitoring of potassium levels and sodium and fluid intake. Midodrine may be considered second-line or where fludrocortisone is contraindicated or poorly tolerated. For patients on clozapine with hypotension in critical care settings, the use of adrenaline to maintain mean arterial pressure should be avoided.Registration:PROSPERO (Registration No. CRD42020191530)
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-05-25T06:44:37Z
      DOI: 10.1177/20451253221092931
      Issue No: Vol. 12 (2022)
       
  • The efficacy of antipsychotics in the treatment of physical aggressive
           behavior in patients with dementia in nursing homes

    • Authors: Sina Nawzad, Wiepke Cahn, Heshu Abdullah-Koolmees
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Patients with dementia often suffer from behavioral changes. A common behavioral change is acute physical aggressive behavior which is the most distressing change. This can lead to harm, which is especially problematic in nursing homes. Despite the serious safety concerns, antipsychotics are often prescribed to combat this problem. This article is aimed to review the evidence of the efficacy of utilizing antipsychotics in acutely treating physical aggressive behavior in patients with dementia in nursing homes. Therefore, a systematic literature search was performed. The results demonstrated that a meta-analysis confirmed statistically significant reduction in physical aggression when risperidone was compared to placebo. However, a randomized controlled trial showed no change in physical aggressive behavior between quetiapine and placebo. More research is needed to fully investigate the benefits of physical aggressive behavior and safety concerns of all the antipsychotics in patients with dementia in nursing homes.
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-05-16T07:00:09Z
      DOI: 10.1177/20451253221097452
      Issue No: Vol. 12 (2022)
       
  • Gut microbiome in schizophrenia and antipsychotic-induced metabolic
           alterations: a scoping review

    • Authors: Raghunath Singh, Nicolette Stogios, Emily Smith, Jiwon Lee, Kateryna Maksyutynsk, Emily Au, David C. Wright, Giada De Palma, Ariel Graff-Guerrero, Philip Gerretsen, Daniel J. Müller, Gary Remington, Margaret Hahn, Sri Mahavir Agarwal
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Schizophrenia (SCZ) is a severe mental disorder with high morbidity and lifetime disability rates. Patients with SCZ have a higher risk of developing metabolic comorbidities such as obesity and diabetes mellitus, leading to increased mortality. Antipsychotics (APs), which are the mainstay in the treatment of SCZ, increase the risk of these metabolic perturbations. Despite extensive research, the mechanism underlying SCZ pathophysiology and associated metabolic comorbidities remains unclear. In recent years, gut microbiota (GMB) has been regarded as a ‘chamber of secrets’, particularly in the context of severe mental illnesses such as SCZ, depression, and bipolar disorder. In this scoping review, we aimed to investigate the underlying role of GMB in the pathophysiology of SCZ and metabolic alterations associated with APs. Furthermore, we also explored the therapeutic benefits of prebiotic and probiotic formulations in managing SCZ and AP-induced metabolic alterations. A systematic literature search yielded 46 studies from both preclinical and clinical settings that met inclusion criteria for qualitative synthesis. Preliminary evidence from preclinical and clinical studies indicates that GMB composition changes are associated with SCZ pathogenesis and AP-induced metabolic perturbations. Fecal microbiota transplantation from SCZ patients to mice has been shown to induce SCZ-like behavioral phenotypes, further supporting the plausible role of GMB in SCZ pathogenesis. This scoping review recapitulates the preclinical and clinical evidence suggesting the role of GMB in SCZ symptomatology and metabolic adverse effects associated with APs. Moreover, this scoping review also discusses the therapeutic potentials of prebiotic/probiotic formulations in improving SCZ symptoms and attenuating metabolic alterations related to APs.
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-05-16T06:58:48Z
      DOI: 10.1177/20451253221096525
      Issue No: Vol. 12 (2022)
       
  • Risperidone-induced neuroleptic malignant syndrome: a case report

    • Authors: Ling Deng, Zhi-Xin Qiu, Mao-Yun Wang
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Neuroleptic malignant syndrome (NMS) is a rare illness that results from reactions to antipsychotics. However, the diagnosis of NMS is challenging due to its atypical clinical presentation and unclear pathogenesis. We report the case of a patient with NMS induced by irregular use of antipsychotics, especially risperidone (RSP). He had typical hyperthermia, muscle rigidity and rhabdomyolysis, which led to renal impairment. We carefully analysed the mechanism by which NMS occurred in this patient. An interesting aspect of the case is the synergistic involvement of risperidone, antidepressants, opioids and stress. Because of these complex predisposing factors, it is difficult to completely rule out the diagnosis of malignant hyperthermia (MH). In addition, the rare phenomenon of elevated lipase and amylase was observed in this patient.
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-05-14T08:40:12Z
      DOI: 10.1177/20451253221094960
      Issue No: Vol. 12 (2022)
       
  • Population pharmacokinetic model and limited sampling strategy for
           clozapine using plasma and dried blood spot samples

    • Authors: Lisanne M. Geers, Dan Cohen, Laura M. Wehkamp, Hans J. van Wattum, Jos G.W. Kosterink, Anton J.M. Loonen, Daan J. Touw
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Background:To improve efficacy, therapeutic drug monitoring is often used in clozapine therapy. Trough level monitoring is regular, but trough levels provide limited information about the pharmacokinetics of clozapine and exposure in time. The area under the concentration time curve (AUC) is generally valued as better marker of drug exposure in time but calculating AUC needs multiple sampling. An alternative approach is a limited sampling scheme in combination with a population pharmacokinetic model meant for Bayesian forecasting. Furthermore, multiple venepunctions can be a burden for the patient, whereas collecting samples by means of dried blood spot (DBS) sampling can facilitate AUC-monitoring, making it more patient friendly.Objective:Development of a population pharmacokinetic model and limited sampling strategy for estimating AUC0-12h (a twice-daily dosage regimen) and AUC0-24h (a once-daily dosage regimen) of clozapine, using a combination of results from venepunctions and DBS sampling.Method:From 15 schizophrenia patients, plasma and DBS samples were obtained before administration and 2, 4, 6, and 8 h after clozapine intake. MwPharm® pharmacokinetic software was used to parameterize a population pharmacokinetic model and calculate limited sampling schemes.Results:A three-point sampling strategy with samples at 2, 6, and 8 h after clozapine intake gave the best estimation of the clozapine AUC0-12h and at 4, 10, and 11 h for the AUC0-24h. For clinical practice, however, a two-point sampling strategy with sampling points at 2 and 6 h was sufficient to estimate AUC0-12h and at 4 and 11 h for AUC0-24h.Conclusion:A pharmacokinetic model with a two–time point limited sampling strategy meant for Bayesian forecasting using DBS sampling gives a better prediction of the clozapine exposure in time, expressed as AUC, compared to trough level monitoring. This limited sampling strategy might therefore provide a more accurate prediction of effectiveness and occurrence of side effects compared to trough level monitoring. The use of DBS samples also makes the collection of clozapine samples easier and wider applicable.
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-05-02T02:24:19Z
      DOI: 10.1177/20451253211065857
      Issue No: Vol. 12 (2022)
       
  • The clinical effectiveness and cost effectiveness of clozapine for
           inpatients with severe borderline personality disorder (CALMED study): a
           randomised placebo-controlled trial

    • Authors: Mike J. Crawford, Verity C. Leeson, Rachel Evans, Barbara Barrett, Aisling McQuaid, Jack Cheshire, Rahil Sanatinia, Gary Lamph, Piyal Sen, Katina Anagnostakis, Louise Millard, Inti Qurashi, Fintan Larkin, Nusrat Husain, Paul Moran, Thomas R.E. Barnes, Carol Paton, Zoe Hoare, Marco Picchioni, Simon Gibbon
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Background:Data from case series suggest that clozapine may benefit inpatients with borderline personality disorder (BPD), but randomised trials have not been conducted.Methods:Multicentre, double-blind, placebo-controlled trial. We aimed to recruit 222 inpatients with severe BPD aged 18 or over, who had failed to respond to other antipsychotic medications. We randomly allocated participants on a 1:1 ratio to receive up to 400 mg of clozapine per day or an inert placebo using a remote web-based randomisation service. The primary outcome was total score on the Zanarini Rating scale for Borderline Personality Disorder (ZAN-BPD) at 6 months. Secondary outcomes included self-harm, aggression, resource use and costs, side effects and adverse events. We used a modified intention to treat analysis (mITT) restricted to those who took one or more dose of trial medication, using a general linear model fitted at 6 months adjusted for baseline score, allocation group and site.Results:The study closed early due to poor recruitment and the impact of the COVID-19 pandemic. Of 29 study participants, 24 (83%) were followed up at 6 months, of whom 21 (72%) were included in the mITT analysis. At 6 months, 11 (73%) participants assigned to clozapine and 6 (43%) of those assigned to placebo were still taking trial medication. Adjusted difference in mean total ZAN-BPD score at 6 months was -3.86 (95% Confidence Intervals = -10.04 to 2.32). There were 14 serious adverse events; 6 in the clozapine arm and 8 in the placebo arm of the trial. There was little difference in the cost of care between groups.Interpretation:We recruited insufficient participants to test the primary hypothesis. The study findings highlight problems in conducting placebo-controlled trials of clozapine and in using clozapine for people with BPD, outside specialist inpatient mental health units.Trial registrationISRCTN18352058. https://doi.org/10.1186/ISRCTN18352058
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-04-30T04:21:08Z
      DOI: 10.1177/20451253221090832
      Issue No: Vol. 12 (2022)
       
  • Analysis of the clinical characteristics of olanzapine-induced acute
           pancreatitis

    • Authors: Yang He, Weijin Fang, Zuojun Li, Linli Sun, Yulu Zhou, Cuifang Wu, Wei Sun, Chunjiang Wang
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Numerous case reports of acute pancreatitis (AP) induced by olanzapine have been published. Little is, however, known about the clinical features of olanzapine-induced AP. The aim of the study was to explore the clinical characteristics of olanzapine-induced AP. We collected literature on AP cases induced by olanzapine from 1996 to April 2021 for retrospective analysis in Chinese and English. The median time to onset of olanzapine-induced acute pancreatic symptoms was 12 (range = 0.86–216) weeks in 25 patients. The clinical features of AP range from asymptomatic elevation of blood amylase/lipase levels to digestive system symptoms (abdominal pain, vomiting, and nausea) and even death in a small number of patients. Laboratory tests showed varying degrees of elevated serum amylase and lipase levels, along with high blood sugar and high triglyceride levels in some patients. Computed tomography showed acute edematous pancreatitis, acute hemorrhagic pancreatitis, and acute necrotizing pancreatitis in the patients. The patients’ symptoms were completely relieved and high triglyceride levels gradually returned to normal levels after olanzapine was stopped. Some patients with hyperglycemia still needed hypoglycemic therapy. AP is a rare adverse effect of olanzapine. Clinicians should be aware of such complications and monitor pancreatin.
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-04-30T04:19:09Z
      DOI: 10.1177/20451253221079971
      Issue No: Vol. 12 (2022)
       
  • Experiences with benzodiazepine use, tapering, and discontinuation: an
           Internet survey

    • Authors: Alistair J. Reid Finlayson, Jane Macoubrie, Christy Huff, Darren E. Foster, Peter R. Martin
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Background:Over 92 million prescriptions for benzodiazepines are dispensed in the United States annually, yet little is known about the experiences of those taking and discontinuing them.Objective:The aim of this study is to assess the experiences of those taking, tapering, or having discontinued benzodiazepines.Methods:An online survey (n = 1207) elicited information about benzodiazepine use, including long-term use, tapering, discontinuation, and withdrawal symptoms.Results:Symptoms associated with benzodiazepine use, tapering, and discontinuation were numerous and ranged from symptoms such as anxiety, insomnia, and nervousness to digestive problems, irregular heart rhythms, uncontrollable anger, photosensitivity, balance problems, and others. When asked how benzodiazepine symptoms affected their lives, 82.9% reported work problems, 86.3% had problems with social interactions and friendships, and 88.8% had problems with fun, recreation, and hobbies. Suicidal thoughts or attempted suicide was reported by 54.4%, and 46.8% said benzodiazepines caused lost employment. Most of the respondents for whom benzodiazepines were prescribed (76.2%) stated they had not been informed that benzodiazepines were indicated for short-term use only and that discontinuation might be difficult. About a third (31.5%) reported food allergies and/or seasonal allergies that occurred only after benzodiazepine use.Conclusion:The trajectory of those who taper or discontinue benzodiazepines is unpredictable, and many patients experience a range of protracted and severe symptoms, even years after benzodiazepines were completely discontinued. Greater awareness is needed for both prescribers and patients about the potential for a difficult withdrawal from benzodiazepines.
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-04-25T07:19:16Z
      DOI: 10.1177/20451253221082386
      Issue No: Vol. 12 (2022)
       
  • Will psilocybin lose its magic in the clinical setting'

    • Authors: Caroline Hayes, Mourad Wahba, Stuart Watson
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Psilocybin as a novel treatment for depression is garnering a lot of attention from both the mainstream media and the academic community. Although phase 3 trials are only just beginning, we feel that it is important for clinicians to consider what psilocybin-assisted psychotherapy might look like in the clinical setting. In this narrative review article we have considered the difficulties that may arise as psilocybin emerges from the research setting, which may hamper its progress towards becoming a licenced medication. Psilocybin has its own unique challenges: the expectation patients come to dosing with having read overwhelmingly positive media; patient suggestibility under the influence of psilocybin and requirement for specialised therapists to name a few. We have also made some recommendations for measures that should be taken in both the phase 3 trials and with clinicians to try and minimise some of the issues raised. In doing so our hope is that psilocybin will continue towards becoming a licenced medication that suitable patients are able to access with relative ease. Practicing psychiatrists need to have an awareness of the potential pitfalls of psilocybin as they will be responsible for prescribing it in the future.
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-04-23T06:51:01Z
      DOI: 10.1177/20451253221090822
      Issue No: Vol. 12 (2022)
       
  • Time to rehospitalization in involuntarily hospitalized individuals
           suffering from schizophrenia discharged on long-acting injectable
           antipsychotics or oral antipsychotics

    • Authors: Ching-Hua Lin, Hung-Yu Chan, Fu-Chiang Wang, Chun-Chi Hsu
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Background:Involuntarily hospitalized individuals suffering from schizophrenia often have a poorer prognosis after discharge.Objective:This study aimed to analyze time to rehospitalization within 6 months of discharge in involuntarily hospitalized individuals suffering from schizophrenia discharged on long-acting injectable antipsychotics (LAIs) or oral antipsychotics (OAPs). In addition, temporal trends in LAI use at discharge were explored.Methods:Involuntarily hospitalized individuals suffering from schizophrenia discharged from the study hospital between 2006 and 2019 (n = 806) were included in the analysis. Survival analysis was used to compare time to rehospitalization within 6 months of discharge between individuals discharged on LAIs and OAPs, and between first-generation antipsychotic (FGA) LAIs and second-generation antipsychotic (SGA) LAIs. The Cochran–Armitage trend test was used to test whether a temporal trend existed for LAIs use at discharge during the study period.Results:The LAIs group (n = 231) had a significantly lower rate of rehospitalization and a significantly longer time to rehospitalization than the OAPs group (n = 575). Rehospitalization rate and time to rehospitalization were not significantly different between individuals discharged on FGA-LAIs and SGA-LAIs. LAIs use at discharge grew significantly from 16.77% in 2006 to 50.00% in 2019 (Z = 6.81, p 
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-03-23T09:59:40Z
      DOI: 10.1177/20451253221079165
      Issue No: Vol. 12 (2022)
       
  • Clozapine- and non-clozapine-associated neutropenia in patients with
           schizophrenia: a retrospective cohort study

    • Authors: Claas-Frederik Johannsen, Tonny Studsgaard Petersen, Jimmi Nielsen, Anders Jørgensen, Espen Jimenez-Solem, Anders Fink-Jensen
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Introduction:The antipsychotic drug clozapine remains underutilized partly because of the risk of life-threatening adverse effects, such as neutropenia. Therefore, an extensive hematological monitoring program was set up to detect neutropenia.Methods:In this retrospective cohort study, we used registry-based data from the Capital Region of Denmark to investigate incidence rates of neutropenia among patients with a diagnosis of schizophrenia or other psychotic disorders and treated with clozapine for the first time. In a within-subject design, we compared rates of neutropenia in time periods where patients were exposed to clozapine versus time periods, where they were not exposed to clozapine. We also investigated whether the lengths of clozapine-associated neutropenia (CAN) were related to discontinuation of clozapine treatment.Results:Data from 520 clozapine users were included. The incidence rate of CAN was 3.2 cases per 100 person-years (95% confidence interval [CI]: 2.1–4.8) throughout the entire study. There was no significant difference in incidence rates of neutropenia during clozapine exposure and non-clozapine exposure, with an incidence rate ratio of 0.7 (95% CI: 0.4–1.3). One episode of severe neutropenia was detected. Episodes of CAN with only one sub-threshold neutrophil count were not associated with higher clozapine discontinuation (26%) than CAN episodes of more than one sub-threshold neutrophil count (28%).Conclusion:In the present study, we could not confirm that clozapine treatment was associated with neutropenia.
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-03-05T09:16:35Z
      DOI: 10.1177/20451253211072341
      Issue No: Vol. 12 (2022)
       
  • Can the use of long-acting injectable antipsychotic preparations be
           increased in routine clinical practice and the benefits realised'

    • Authors: Carol Paton, Chike I. Okocha, Maxine X. Patel
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Background:The use of continuing antipsychotic medication is an established evidence-based strategy for preventing relapse in people with schizophrenia, but medication adherence is known to be suboptimal. Covert non-adherence can be eliminated by the use of long-acting injectable (LAI) formulations. We sought to (1) raise awareness among clinicians of the potential benefits of LAI antipsychotic formulations, (2) increase use of these formulations for the treatment of schizophrenia in routine clinical practice and thereby (3) reduce the number of relapses requiring hospitalisation in patients with schizophrenia under our care.Method:Educational initiatives, promotion of reflective practice and patient-specific reminders were used to prompt increased use of LAI antipsychotic medication for patients with schizophrenia. Data relating to the use of these medications and the number of acute admissions for schizophrenia spectrum disorders (F20-29, ICD-10) over time were extracted from existing clinical information systems.Results:Over the 3-year time frame of our local initiative, the use of LAI antipsychotic preparations increased by 11%, the number of acute admissions for schizophrenia/schizoaffective disorder (F20 and F25) decreased by 26% and the number of acute bed days occupied by patients with these diagnoses decreased by 8%. The number of admissions for other psychosis diagnoses (F21-24 and F28-29) did not show the same pattern of improvement.Conclusion:In our health care organisation, raising clinicians’ awareness of the evidence base relating to the potentially favourable benefit–risk balance for LAI antipsychotic medication compared with oral formulations resulted in more use of the former. There were accompanying reductions in acute admissions and occupied bed days for patients with schizophrenia.
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-02-15T08:02:44Z
      DOI: 10.1177/20451253211072347
      Issue No: Vol. 12 (2022)
       
  • Clinical practice guideline recommendations on tapering and discontinuing
           antidepressants for depression: a systematic review

    • Authors: Anders Sørensen, Karsten Juhl Jørgensen, Klaus Munkholm
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Background:Tapering and discontinuing antidepressants are important aspects of the management of patients with depression and should therefore be considered in clinical practice guidelines.Objectives:We aimed to assess the extent and content, and appraise the quality, of guidance on tapering and discontinuing antidepressants in major clinical practice guidelines on depression.Methods:Systematic review of clinical practice guidelines on depression issued by national health authorities and major national or international professional organisations in the United Kingdom, the United States, Canada, Australia, Singapore, Ireland and New Zealand (PROSPERO CRD42020220682). We searched PubMed, 14 guideline registries and the websites of relevant organisations (last search 25 May 2021). The clinical practice guidelines were assessed for recommendations and information relevant to tapering and discontinuing antidepressants. The quality of the clinical practice guidelines as they pertained to tapering and discontinuation was assessed using the AGREE II tool.Results:Of the 21 included clinical practice guidelines, 15 (71%) recommended that antidepressants are tapered gradually or slowly, but none provided guidance on dose reductions, how to distinguish withdrawal symptoms from relapse or how to manage withdrawal symptoms. Psychological challenges were not addressed in any clinical practice guideline, and the treatment algorithms and flow charts did not include discontinuation. The quality of the clinical practice guidelines was overall low.Conclusion:Current major clinical practice guidelines provide little support for clinicians wishing to help patients discontinue or taper antidepressants in terms of mitigating and managing withdrawal symptoms. Patients who have deteriorated upon following current guidance on tapering and discontinuing antidepressants thus cannot be concluded to have experienced a relapse. Better guidance requires better randomised trials investigating interventions for discontinuing or tapering antidepressants.
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-02-11T10:36:58Z
      DOI: 10.1177/20451253211067656
      Issue No: Vol. 12 (2022)
       
  • Clinical outcomes following switching antipsychotic treatment due to
           market withdrawal: a retrospective naturalistic cohort study of
           pipotiazine palmitate injection (Piportil Depot) discontinuation,
           subsequent acute care use and effectiveness of medication to which
           patients switched

    • Authors: Rollo J.G. Sheldon, Marco Pereira, George Aldersley, Tim Sales, Jed Hewitt, Ray Lyon, Richard Whale
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Introduction:Pipotiazine palmitate depot injection (Piportil) was withdrawn from the UK marketplace in 2015. Few studies exist on the clinical impact of such market withdrawal. Purpose: We aimed to identify a cohort of patients switching from pipotiazine following this withdrawal and explore factors associated with effectiveness of the medication switched to and subsequent acute service use.Methods:A naturalistic retrospective cohort study was conducted in Sussex, United Kingdom. Those discontinuing pipotiazine solely due to market withdrawal were identified from electronic patient database and manual searching. Multivariate logistic regression analyses and survival analyses were performed to explore associations between available baseline variables and dichotomous all-cause discontinuation of the next prescribed medication and admission to acute mental health services over the subsequent year.Results:Of 205 patients identified as receiving pipotiazine in October 2014, 137 switched from this due to market withdrawal. Over the subsequent year, 31.5% discontinued the medication to which they were switched and 19% required acute care. Drug class switched to (typical depot vs atypical long acting injection (LAI) vs atypical oral) had no significant association with discontinuation. Switch to atypical LAI was significantly associated with acute care in comparison to typical depot. Those with a schizophrenia diagnosis were significantly less likely to discontinue switched medication or to receive acute care in comparison to those with schizoaffective disorder. Women were significantly more likely to discontinue switched medication than men. Of those requiring acute care, only 38% had required this in the previous 2 years.Conclusions:Antipsychotic market withdrawal has demonstrable negative clinical implications and requires careful clinical management. Increased acute care rates in those receiving an atypical LAI versus a typical depot following pipotiazine suggests lower effectiveness or possible withdrawal effects. No significant difference between depots, LAIs and oral medications on discontinuation supports the importance of a collaborative, fully informed approach when deciding next treatment options.
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-01-31T04:40:05Z
      DOI: 10.1177/20451253211067042
      Issue No: Vol. 12 (2022)
       
  • Clozapine augmentation with cariprazine for negative symptoms: a case
           series and literature review

    • Authors: Ebenezer Oloyede, Ivana Clark, Shubhra Mace, Eromona Whiskey, David Taylor
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Only about 50% of patients with treatment-resistant schizophrenia respond to clozapine, and many more patients continue to experience ongoing and prominent negative symptoms. These negative symptoms, for which there are limited pharmacological options, may represent the greatest barrier to functional recovery. Cariprazine is a novel antipsychotic drug that is a partial agonist at dopamine D2 and D3 receptors with preferential binding to the D3 receptor, antagonism of 5HT2B receptors, and partial agonism at 5HT1A receptors. Cariprazine is currently licenced for the treatment of schizophrenia in Europe and the United States and has also been approved for bipolar disorder in the United States. There is a limited body of evidence to suggest clinical effectiveness as an augmentation strategy for negative symptoms in those treated with clozapine. In this case series, we present five cases of successful treatment of negative symptoms by clozapine combined with cariprazine in treatment-resistant psychosis.
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-01-28T12:21:33Z
      DOI: 10.1177/20451253211066642
      Issue No: Vol. 12 (2022)
       
  • Brugada syndrome: should we be screening patients before prescribing
           psychotropic medication'

    • Authors: Azizah Attard, Claire Stanniland, Stephen Attard, Andrew Iles, Kim Rajappan
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Brugada syndrome (BrS) presents with a characteristic electrocardiogram (ECG) and is associated with sudden cardiac death. Until now, prolongation of QTc interval and its association with Torsade de Pointe and possible fatal arrhythmia have been the focus of routine baseline ECGs before prescribing psychotropic medication. A semi-systematic literature review was conducted using PubMed. The terms ‘Brugada’, ‘Brugada Syndrome’ AND ‘psychotropic’ ‘antipsychotic’ ‘antidepressant’ ‘mood stabilisers’ ‘clozapine’ ‘Tricyclic Antidepressants’ ‘Lithium’ were searched. From a search that delivered over 200 articles, 82 articles were included. Those that included details around causative medication, doses of medication and where clear timeline on drug cause were included. Where clarification was needed, the manufacturer of the medication was contacted directly. Psychotropic medication can be associated with BrS, Brugada phenocopy or unmasking of BrS, in overdose or in normal doses. Our results include a table summarising a number of psychotropic overdoses that led to BrS unmasking. Routine screening for BrS in patients before prescribing psychotropic medication is a natural extension of the baseline ECG currently routinely done to rule out QTc prolongation. Psychiatrists need to invest in ensuring better skills in interpreting ECGs and work closer with cardiologists in interpreting ECGs.
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-01-28T10:16:12Z
      DOI: 10.1177/20451253211067017
      Issue No: Vol. 12 (2022)
       
  • Advances in pharmacotherapy for postpartum depression: a structured review
           of standard-of-care antidepressants and novel neuroactive steroid
           antidepressants

    • Authors: Yardana Kaufman, Sara V. Carlini, Kristina M. Deligiannidis
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Postpartum depression is one of the most common morbidities of childbearing, yet it is underdiagnosed and undertreated with negative consequences for mother and offspring. Despite the widespread use of standard-of-care antidepressants as the mainstay of treatment for postpartum depression, there is limited evidence on their safety and efficacy due to their slow onset of action and suboptimal outcomes. The emergence of gamma-aminobutyric acidergic neuroactive steroids may offer faster response and remission times and improved patient outcomes. This article reviews the evidence base for the efficacy of standard-of-care antidepressants, hormonal therapeutics including progestins and estradiol, and gamma-aminobutyric acidergic neuroactive steroids in the treatment of postpartum depression, as well as the safety of infant exposure to these agents during lactation.
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-01-28T10:14:32Z
      DOI: 10.1177/20451253211065859
      Issue No: Vol. 12 (2022)
       
  • Identifying dopamine supersensitivity through a randomized controlled
           study of switching to aripiprazole from other antipsychotic agents in
           patients with schizophrenia

    • Authors: Chia-Hao Ma, Hung-Yu Chan, Ming H. Hsieh, Chen-Chung Liu, Chih-Min Liu, Hai-Gwo Hwu, Ching-Hua Kuo, Wei J. Chen, Tzung-Jeng Hwang
      Abstract: Therapeutic Advances in Psychopharmacology, Volume 12, Issue , January-December 2022.
      Background:Aripiprazole has been reported to worsen psychotic symptoms when switching from other antipsychotics, possibly due to dopamine supersensitivity psychosis.Objective:This study aimed to explore the predictors and possible underlying mechanisms of aripiprazole-related psychotic exacerbation.Methods:We conducted an 8-week, open-label, randomized controlled study from October 2007 to September 2009, assigning patients with a primary diagnosis of schizophrenia or schizoaffective disorder to switch from other antipsychotics to aripiprazole with 2-week dual administration, and then to taper off the original agents in fast (n = 38, within 1 week) or slow (n = 41, within 4 weeks) strategies. Positive and Negative Syndrome Scale (PANSS) was examined at day 0, 7, 14, 28, 56. Aripiprazole-related exacerbation (ARE) was defined positive as a 2-point increase in delusion/hallucination dimension score within 28 days compared with baseline. Baseline demographic, clinical and intervention-related variables were compared between the ARE+ and ARE- groups.Results:Of the 79 randomized patients, 21 fulfilled the criteria of ARE+ , and 46 were classified as ARE-. Fourteen patients in the ARE+ group had worsening psychotic symptoms in the first and second weeks. Compared with the ARE- group, the ARE+ group had a higher baseline chlorpromazine equivalent dose (405.8 ± 225.8 mg vs 268.1 ± 165.4 mg, p = 0.007) and was associated with prescription of first-generation antipsychotics (p = 0.038).Conclusions:A higher dose of original antipsychotics and prescription of first-generation antipsychotics may be associated with a higher risk of ARE. The underlying mechanism might be covert dopamine supersensitivity psychosis. These findings may help to identify high-risk patients and guide appropriate treatment strategies.Trial Registration:ClinicalTrials.gov, identifier: NCT00545467
      Citation: Therapeutic Advances in Psychopharmacology
      PubDate: 2022-01-28T10:12:46Z
      DOI: 10.1177/20451253211064396
      Issue No: Vol. 12 (2022)
       
 
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