Journal articles on the topic 'Antipsychotic drugs'
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1
Meltzer, Herbert Y. "The Importance of Serotonin-Dopamine Interactions in the Action of Clozapine." British Journal of Psychiatry 160, S17 (May 1992): 22–29. http://dx.doi.org/10.1192/s0007125000296876.
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Clozapine has an affinity for the dopamine (DA) D2 receptor which is relatively weak but is in line with its average clinical dose when compared with typical neuroleptic drugs. A few atypical antipsychotic drugs may have high absolute affinities for the D2 receptor, but most are weak D2 blockers. The atypical antipsychotic drugs also differ from the typical antipsychotic drugs by a relatively high affinity for the serotonin (5-HT2) receptor. This is evident on both in vitro and in vivo binding to cortical 5-HT2 receptors. The atypical antipsychotics are best distinguished from the typical antipsychotics on the basis of the relationship between strong 5-HT2 and weak D2 affinities. High D1 receptor binding is not characteristic of the group of atypical drugs. A new group of putative atypical antipsychotic drugs with high affinities for 5-HT2 compared to D2 receptors is under study.
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I Bon, Elizaveta. "The Place of Antipsychotics in the Treatment of Anxiety Disorders." Neuroscience and Neurological Surgery 14, no. 04 (June 12, 2024): 01–03. http://dx.doi.org/10.31579/2578-8868/316.
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Antipsychotic drugs, also known as antipsychotic drugs, are used to treat a variety of mental disorders and symptoms. They are divided into two classes: first-generation, or “typical”, antipsychotics, and second-generation, or “atypical” antipsychotics. These drugs are used for a variety of neuropsychiatric conditions such as ADHD (attention deficit hyperactivity disorder), depression, insomnia, anxiety disorders, PTSD (post-traumatic stress disorder), eating disorders, personality disorders and others.
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Andriani, Yuni, Frisca Nindy Septiani, and Defirson Defirson. "Cost-effectiveness of Antipsychotics in Treatment of Schizophrenia Patients admitted to a secondary Hospital." Indonesian Journal of Pharmaceutical and Clinical Research 2, no. 2 (December 31, 2019): 43–52. http://dx.doi.org/10.32734/idjpcr.v2i2.454.
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Abstract. Schizophrenia is a chronic disease that requires relatively high treatment costs [1]. Several studies have found that atypical antipsychotics are more effective compared to typical antipsychotics. As a result, the duration of treatment and the patients’ length of hospital stay will be shorter which ultimately reduce the overall treatment costs. Therefore, it is necessary to conduct a cost-effectiveness analysis (CEA) of the two classes of antipsychotic drugs in the treatment of schizophrenia inpatients admitted to Jambi Province Hospital period 2013-2016. Method: This descriptive retrospective cohort study was undertaken to analyze cost-effectiveness of the antipsychotic drugs provided to patients with schizophrenia (n=910) admitted to Jambi Province Hospital from the perspective of a healthcare provider. using purposive sampling technique. Characteristics of the patients, antipsychotic drugs usage, costs consumed, and treatment outcome were extracted from the hospital databases. Results: It was found that the total ACER value of the typical antipsychotic group was Rp. 142,789.25 and atypical antipsychotics is IDR 163,045.50 which indicates that the typical ACER antipsychotic value is smaller than those of atypical antipsychotics based on the length of stay of patients in the Psychiatric Intensive Care Unit (PICU) room. Whereas based on the PANSS-EC score of the patient, the total ACER value of the typical antipsychotic group was IDR1,189,910.42 and in atypical antipsychotics was IDR. 572,089.47. Conclusion: Atypical antipsychotics are more cost-effective than typical antipsychotics.
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Markowitz, John S., Barbara G. Wells, and William H. Carson. "Interactions Between Antipsychotic and Antihypertensive Drugs." Annals of Pharmacotherapy 29, no. 6 (June 1995): 603–9. http://dx.doi.org/10.1177/106002809502900610.
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Objective: To provide a comprehensive review of the pharmacokinetic and pharmacodynamic interactions between antipsychotics and antihypertensives and to provide recommendations for the selection of antihypertensives in patients receiving antipsychotic therapy. Data Sources: A MEDLINE search of the English-language literature was used to identify pertinent human and animal studies, reviews, and case reports. Study Selection: All available sources were reviewed. Data Extraction: Background information was obtained from comprehensive reviews. Individual case reports were assimilated, and pertinent data were extracted. Data Synthesis: Because hypertension is common in patients with psychiatric illness and antihypertensive agents are used for a multiplicity of indications, significant numbers of patients receive concurrent therapy with antihypertensives and antipsychotics. Many antipsychotics may block the antihypertensive efficacy of guanethidine and related drugs. The interaction between Clonidine and antipsychotics is defined less clearly. Limited data suggest possible additive hypotensive effects when chlorpromazine and methyldopa are given in combination. Increased plasma concentrations of thioridazine with a resultant increase in adverse effects have been reported when propranolol or pindolol are added to the regimen. A similar increase in chlorpromazine concentrations has been reported when propranolol was added. Although there are no reports documenting an interaction between a calcium-channel antagonist and an antipsychotic, the possible inhibition of oxidative metabolism of antipsychotics, additive calcium-blocking activity, and additive pharmacodynamic effects are theorized. Hypotension and postural syncope were reported in a patient given therapeutic dosages of chlorpromazine and Captopril, and in 2 patients when clozapine was added to enalapril therapy. Conclusions: No antipsychotic-antihypertensive combination is absolutely contraindicated, but no combination should be considered to be completely without risk. Antihypertensives with no centrally acting activity, such as diuretics, may be the least likely to result in adverse reactions. The combination of the beta-antagonists propranolol or pindolol with thioridazine or chlorpromazine should be avoided if possible. Scrupulous patient monitoring for attenuated or enhanced activity of either agent is essential whenever antipsychotics and antihypertensives are given concurrently.
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Rybakowski, Janusz K. "Application of Antipsychotic Drugs in Mood Disorders." Brain Sciences 13, no. 3 (February 27, 2023): 414. http://dx.doi.org/10.3390/brainsci13030414.
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Since their first application in psychiatry seventy years ago, antipsychotic drugs, besides schizophrenia, have been widely used in the treatment of mood disorders. Such an application of antipsychotics is the subject of this narrative review. Antipsychotic drugs can be arbitrarily classified into three generations. First-generation antipsychotics (FGAs), such as phenothiazines and haloperidol, were mainly applied for the treatment of acute mania, as well as psychotic depression when combined with antidepressants. The second-generation, so-called atypical antipsychotics (SGAs), such as clozapine, risperidone, olanzapine, and quetiapine, have antimanic activity and are also effective for the maintenance treatment of bipolar disorder. Additionally, quetiapine exerts therapeutic action in bipolar depression. Third-generation antipsychotics (TGAs) started with aripiprazole, a partial dopamine D2 receptor agonist, followed by brexpiprazole, lurasidone, cariprazine, and lumateperone. Out of these drugs, aripiprazole and cariprazine have antimanic activity, lurasidone, cariprazine, and lumateperone exert a significant antidepressant effect on bipolar depression, while there is evidence for the efficacy of aripiprazole and lurasidone in the prevention of recurrence in bipolar disorder. Therefore, successive generations of antipsychotic drugs present a diverse spectrum for application in mood disorders. Such a pharmacological overlap in the treatment of schizophrenia and bipolar illness stands in contrast to the dichotomous Kraepelinian division of schizophrenia and mood disorders.
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Shoja Shafti, Saeed. "Neuroleptic Malignant Syndrome: Typical Antipsychotic Drugs Versus Atypical Antipsychotic Medications." Brain and Neurological Disorders 5, no. 2 (June 21, 2022): 01–04. http://dx.doi.org/10.31579/2642-9730/025.
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Introduction: Neuroleptic malignant syndrome is an idiosyncratic reaction and a severe disorder caused by an adverse reaction to drugs with dopamine receptor- antagonist properties and is characterized by a tetrad of rigidity, fever, altered mental status, and autonomic instability. In the present assessment, typical or conventional antipsychotics have been contrasted with atypical antipsychotics with respect to recorded cases of neuroleptic malignant syndrome among a sample of nonwestern psychiatric inpatients. Methods: For assessment, all the cases with a diagnosis of neuroleptic malignant syndrome during the last sixty-two months, after exclusion of other conceivable differential diagnoses, were incorporated in the current retrospective, record-based evaluation. The clinical diagnosis was based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. The valuation of independent variables was analyzed by ‘Compression of proportions. Statistical significance is defined as p value ≤0.05. Results: Amongst 19814 psychiatric inpatients, in the course of sixty-two months, eighteen cases received the diagnosis of neuroleptic malignant syndrome. As said by the findings, neuroleptic malignant syndrome was meaningfully more frequent among males, in comparison with females, and it was importantly more prevalent among cases suffering from schizophrenia, in comparison with bipolar disorder. Also, the highest risk of neuroleptic malignant syndrome was found in the age group of 30-39. In the current assessment, only one of the patients, who had received haloperidol, died due to aspiration pneumonia and respiratory failure, and the most prevalent symptom was fever, which was observable in one hundred percent of cases. In addition to a similar clinical profile, ‘Compression of proportions’ did not show any significant difference between the conventional (typical) antipsychotics versus the atypical antipsychotic medications with respect to the occurrence of neuroleptic malignant syndrome. Conclusion: As said by the findings, no significant difference was evident between the typical antipsychotic drugs versus the atypical antipsychotic medications, with respect to incidence and clinical profile of neuroleptic malignant syndrome.
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Abdelmawla, Nasser, and Alex J. Mitchell. "Sudden cardiac death and antipsychotics Part 2: Monitoring and prevention." Advances in Psychiatric Treatment 12, no. 2 (March 2006): 100–109. http://dx.doi.org/10.1192/apt.12.2.100.
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Cardiac safety of antipsychotic drugs continues to be a concern for both typical and atypical antipsychotics. Risk appears greatest in those with pre-existing cardiac disease but many patients may have occult cardiovascular disease. In addition, several drugs appear to increase the likelihood of diabetes and weight gain, which may have an additive adverse effect. On the basis of risk of sudden cardiac death and risk of QTc prolongation we suggest considering antipsychotics in two categories – higher and lower risk. Of most concern is the use of large cumulative doses of antipsychotics that are sometimes given inadvertently by different prescribers. Clinicians need to be aware how to read an ECG, and how to monitor physical parameters and interpret the significance of QTc prolongation in relation to antipsychotic prescribing. We suggest provisional guidance on antipsychotic monitoring in relation to cardiac safety but acknowledge that future studies will help clarify which antipsychotic drugs and which concomitant risk factors are most important for those with and without established cardiac disease.
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Tournier, M., A. Cougnard, B. Bégaud, A. Thiébaut, and H. Verdoux. "The Metabolic Impact of the Antipsychotic Drugs in Patients with Bipolar Disorder." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70490-0.
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Objective:To assess the metabolic impact of adding an antipsychotic to a mood stabilizer or switching a mood stabilizer to an antipsychotic in patients with bipolar disorder.Methods:A retrospective fixed cohort study was conducted through the claims database of the French health care program for the self-employed workers. The study population consisted of 3.172 patients age 18 and over who were exposed to mood stabilizers (i.e. lithium, valproate) a 3 month-period in 2004 without dispensing of non-sedative antipsychotic, antidiabetic or lipid-lowering drugs. The outcome was the occurrence of a metabolic incident over the follow-up period, using the dispensing of an antidiabetic drug as a marker of diabetes and the dispensing of a lipid-lowering drug as a marker of hypercholesterolemia or hypertriglyceridemia. A Cox proportional hazard model was used to assess the metabolic impact of the antipsychotics; using mood stabilizers as a reference. Antipsychotic exposition was stratified in «current» and «recent» (discontinued for less than 6 months) at the time of the metabolic incident.Results:196 patients (6.2%) received a first-generation antipsychotic, 352 (11.1%) a second-generation antipsychotic, 565 (17.8%) a sedative antipsychotic and 367 patients (11.6%) presented with a metabolic incident over the study period. The recent dispensing of a second-generation antipsychotic was associated with the occurrence of a metabolic incident [HR 2.1 (95%CI 1.2-3.7) p=0.006], while current dispensing or dispensing of first-generation antipsychotics were not.Conclusion:Second-generation antipsychotics have a metabolic impact compared to classic mood stabilizers in patients with bipolar disorder.
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El-Khayat, Redwan, and David S. Baldwin. "Antipsychotic drugs for non-psychotic patients." Psychiatric Bulletin 23, no. 7 (July 1999): 416–18. http://dx.doi.org/10.1192/pb.23.7.416.
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Aims and methodThe aim of this study was to examine the pattern and basis of use of psychotropic drug prescriptions by psychiatrists to relieve anxiety symptoms arising from non-psychotic disorders. A questionnaire survey was conducted among senior psychiatrists in the Wessex region.ResultsThe response rate was 74%. A range of psychotropic drugs was used to treat non-psychotic anxiety symptoms, most commonly selective serotonin re-uptake inhibitors, tricyclic antidepressants and antipsychotic drugs. Antipsychotic drugs are reserved for second- and third-line treatments, mainly in low doses but sometimes in high doses and for long periods. The use of antipsychotic drugs as anxiolytics was seen by the majority of responders as reasonable practice, and they are considered suitable alternatives to benzodiazepines. This practice was based mainly on personal experience.Clinical implicationsAnxiety symptoms arising from non-psychotic disorders are common in the out-patient population. Although antipsychotics are used by psychiatrists to relieve these symptoms, the ‘evidence base’ for such practice is flimsy and mainly based on clinical experience. The benefit/risk ratio should be considered carefully before prescribing antipsychotics for non-psychotic anxiety. Further research is needed in this area, contributing towards general guidelines.
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Grundmann, Milan, Ivana Kacirova, and Romana Urinovska. "Therapeutic drug monitoring of atypical antipsychotic drugs." Acta Pharmaceutica 64, no. 4 (December 1, 2014): 387–401. http://dx.doi.org/10.2478/acph-2014-0036.
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Abstract Schizophrenia is a severe psychiatric disorder often associated with cognitive impairment and affective, mainly depressive, symptoms. Antipsychotic medication is the primary intervention for stabilization of acute psychotic episodes and prevention of recurrences and relapses in patients with schizophrenia. Typical antipsychotics, the older class of antipsychotic agents, are currently used much less frequently than newer atypical antipsychotics. Therapeutic drug monitoring (TDM) of antipsychotic drugs is the specific method of clinical pharmacology, which involves measurement of drug serum concentrations followed by interpretation and good cooperation with the clinician. TDM is a powerful tool that allows tailor-made treatment for the specific needs of individual patients. It can help in monitoring adherence, dose adjustment, minimizing the risk of toxicity and in cost-effectiveness in the treatment of psychiatric disorders. The review provides complex knowledge indispensable to clinical pharmacologists, pharmacists and clinicians for interpretation of TDM results.
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Meiyanti, Meiyanti, Lyfanni Fiesa Mulia, and Mulia, Pusparini. "The Relationship between Antipsychotic Drug Use and Liver Enzyme Levels in People with Mental Disorders." Journal of Drug Delivery and Therapeutics 12, no. 1 (January 15, 2022): 7–11. http://dx.doi.org/10.22270/jddt.v12i1.5266.
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The long-term use of some drugs causes side effects in the form of elevated liver enzyme levels. Meanwhile, antipsychotic drug therapy in people with mental disorders induces liver injury which leads to an elevation in serum glutamic oxaloacetic and pyruvic transaminases. Therefore, this study aims to analyze the relationship between the uses of antipsychotic drugs with elevated liver enzymes in people with mental disorders. This observational study used a cross-sectional design that included 69 people with mental disorders. The respondents were selected based on consecutive non-random sampling, while the data were collected using a questionnaire to obtain the universal characteristics of the subjects, therapy duration, and antipsychotic type, as well as an examination of AST and ALT levels using the ultraviolet test method. Furthermore, data analysis was conducted using the chi-Square test with a significance level of p<0.05. The results showed that thirty-two among the respondents or 46.4% used atypical antipsychotics, while 37 or 73.0% received the drugs for 1-6 months. In the subjects receiving typical antipsychotics, 10 or 55.6% had a significant elevation in liver enzymes compared to others receiving atypical antipsychotics namely 6 (18.8%) or a combination of both drugs namely 6 (31.6%). Therefore, the type of antipsychotic used in therapy has a significant relationship with elevated liver enzymes in people with mental disorders (p=0.028).
Keywords: antipsychotics, drugs, elevated
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Grinchii, Daniil, and Eliyahu Dremencov. "Mechanism of Action of Atypical Antipsychotic Drugs in Mood Disorders." International Journal of Molecular Sciences 21, no. 24 (December 15, 2020): 9532. http://dx.doi.org/10.3390/ijms21249532.
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Atypical antipsychotic drugs were introduced in the early 1990s. Unlike typical antipsychotics, which are effective only against positive symptoms of schizophrenia, atypical antipsychotics are effective against negative and cognitive symptoms as well. Furthermore, they are effective not only in psychotic but also in affective disorders, on their own or as adjuncts to antidepressant drugs. This review presents the neural mechanisms of currently existing atypical antipsychotics and putative antipsychotics currently being investigated in preclinical and clinical studies and how these relate to their effectiveness in mood disorders such as depression, anxiety, and post-traumatic stress disorder (PTSD). Typical antipsychotics act almost exclusively on the dopamine system. Atypical drugs, however, modulate serotonin (5-HT), norepinephrine, and/or histamine neurotransmission as well. This multimodal mechanism of action putatively underlies the beneficial effect of atypical antipsychotics in mood and anxiety disorders. Interestingly, novel experimental drugs having dual antipsychotic and antidepressant therapeutic potential, such as histamine, adenosine, and trace amine-associated receptors (TAAR) ligand, are also characterized by a multimodal stimulatory effect on central 5-HT, norepinephrine, and/or histamine transmission. The multimodal stimulatory effect on central monoamine neurotransmission may be thus primarily responsible for the combined antidepressant and antipsychotic therapeutic potential of certain central nervous system (CNS) drugs.
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T Bwalya, Francisca, James Mwanza, and Paul Ravi. "Trends of Anticholinergics and Antipsychotics Prescribing at Chainama Hills College Hospital, Lusaka-Zambia." Journal of Preventive and Rehabilitative Medicine 3, no. 2 (June 1, 2021): 24–31. http://dx.doi.org/10.21617/jprm2021.327.
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Introduction:Antipsychotics are the main pharmacological treatment for psychosis. Anticholinergic drugs are sometimes prescribed with antipsychotics to treat or as prophylaxis for extrapyramidal side effects. Antipsychotic treatment guidelines recommend that anticholinergics should not be prescribed indiscriminately as prophylaxis for extrapyramidal side effects to patients using antipsychotic drugs, but only when there is high risk or evidence of extrapyramidal side effects, as they can cause significant central and peripheral side effects which have a potential to affect treatment outcomes. The objective of the study was to assess the trends in the prescribing of antipsychotics and anticholinergics.Methods:A cross sectional study was conducted at Chainama Hills College Hospital in Zambia. An open-ended questionnaire was administered to 26 prescribers and 311 files for patients were reviewed who had an antipsychotic or anticholinergic drug prescribed. The prescription pattern of patient files was compared with theNational Institute for Health and Care Excellenceguidelines as a gold standard.Results:The antipsychotic distribution showed that 76.1% were prescribed a typical antipsychotic, 18.1% an atypical antipsychotic and 5.8% were on both typical and atypical antipsychotic. 28.2% of the patients on antipsychotics were prescribed anticholinergics (Trihexyphenidyl). 46.2% of the prescribing clinicians stated that they prescribe anticholinergics when a patient develops extrapyramidal side effects rather than concurrently with antipsychotics or when a high dose of antipsychotics has been prescribed.Conclusion:The trend in antipsychotic and anticholinergic prescribing in Lusaka-Zambia were not consistent with recommended guidelines. Majority of patients are on typical antipsychotics rather than atypical antipsychotics. Most patients were administered above optimal dose of antipsychotics though polypharmacy was solemnly practiced. Recommend that further studies to explore factors contributing to this trend are conducted.
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Edinoff, Amber N., Emily D. Ellis, Laura M. Nussdorf, Taylor W. Hill, Elyse M. Cornett, Adam M. Kaye, and Alan D. Kaye. "Antipsychotic Polypharmacy-Related Cardiovascular Morbidity and Mortality: A Comprehensive Review." Neurology International 14, no. 1 (March 17, 2022): 294–309. http://dx.doi.org/10.3390/neurolint14010024.
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Schizophrenia is a psychotic disorder that exists at the more extreme end of a spectrum of diseases, and significantly affects daily functioning. Cardiovascular adverse effects of antipsychotic medications are well known, and include changes in blood pressure and arrhythmias. Sudden cardiac death is the leading cause of death worldwide, and antipsychotic medications are associated with numerous cardiac side effects. A possible link exists between antipsychotic medications and sudden cardiac death. Common prescribing patterns that may influence cardiovascular events include the use of multiple antipsychotics and/or additional drugs commonly prescribed to patients on antipsychotics. The results of this review reflect an association between antipsychotic drugs and increased risk of ventricular arrhythmias and sudden cardiac death by iatrogenic prolongation of the QTc interval. QTc prolongation and sudden cardiac death exist in patients taking antipsychotic monotherapy. The risk increases for the concomitant use of specific drugs that prolong the QTc interval, such as opioids, antibiotics, and illicit drugs. However, evidence suggests that QTc intervals may not adequately predict sudden cardiac death. In considering the findings of this narrative review, we conclude that it is unclear whether there is a precise association between antipsychotic polypharmacy and sudden cardiac death with QTc interval changes. The present narrative review warrants further research on this important potential association.
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Souza, Valéria Barreto Novais e., Francisco José Rodrigues de Moura Filho, Fábio Gomes de Matos e. Souza, Camila Farias Rocha, Fernando Antônio Mendes Lopes Furtado, Tiago Bessa Almeida Gonçalves, and Karla Feitosa Ximenes Vasconcelos. "Cataract occurrence in patients treated with antipsychotic drugs." Revista Brasileira de Psiquiatria 30, no. 3 (September 2008): 222–26. http://dx.doi.org/10.1590/s1516-44462008000300008.
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OBJECTIVE: Typical antipsychotic drugs, mainly phenothiazines, have been associated with cataract formation for over forty years. Recently, there has been a concern about atypical antipsychotic drugs' potential for inducing this lenticular pathology. Accordingly, we sought to determine the cataract rate and other ocular side effects in patients on long-term therapy with antipsychotic drugs. METHOD: Eighty outpatients with DSM-IV diagnosis of schizophrenia from two settings who met pre determined inclusion criteria were submitted to an ophthalmological evaluation for ocular abnormalities with emphasis in the lens and cornea. They were divided into two groups: group 1 (n = 52) comprised patients who had been predominantly on typical antipsychotics for at least two years and group 2 (n = 28) patients who had been predominantly on atypical antipsychotics for at least two years. RESULTS: Cataract was found in 26 patients (33%) with predominance of anterior capsular cataract. The cataract rate among patients from group 1 (40%) was higher than among those from group 2 (18%). Visual acuity was reduced in 21 patients (26%). No changes were observed neither in the cornea nor in the retina. CONCLUSIONS: Patients using antipsychotic drugs should be submitted to a periodic ophthalmological evaluation.
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Dobrodeeva, V. S., N. A. Shnayder, K. O. Mironov, and R. F. Nasyrova. "Pharmacogenetic markers of antipsychotic-induced weight gain: leptin and neuroepeptide Y." V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, no. 1 (April 12, 2021): 3–10. http://dx.doi.org/10.31363/2313-7053-2021-1-3-10.
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Antipsychotic drugs are a critical modality in managing of schizophrenia. Although medications can be highly effective, response varies and some patients derive considerably less benefit than others. Long-term use of antipsychotic drugs is associated with the development of adverse reactions. Te safety advantages of the atypical drugs havebeen questioned because of their propensity to induce weight gain and alter glucose and lipid metabolism. Antipsychotic-induced weight gain is a common cause of self-discontinuation of treatment and a significant deterioration in the quality of life in patients with schizophrenia. Te severity of adverse reactions when taking antipsychotics in different patients varies, which be associated with genetic factors. Antipsychotic induced weight gain is a major health concern and unfortunately, there is no predictive tool to identify who are high risk individuals. Te LEP, LEPR and NRY genes represents a compellings candidates for genetic studies of antipsychotic-induced weight gain. Candidate gene selection should rely on current knowledge on the molecular pathways to weight gain, antipsychotic pharmacokinetics and pharmacodynamics, as well as possible disease-related genetic links to the side effects under study. Pharmacogenetics will provide rational treatment based on matching antipsychotics to a patient’s DNA profile, thus, potentially providing effective treatment with minimal side effects to outliers and mean responders to a given antipsychotic medication.
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Cookson, John. "Use of antipsychotic drugs and lithium in mania." British Journal of Psychiatry 178, S41 (June 2001): s148—s156. http://dx.doi.org/10.1192/bjp.178.41.s148.
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BackgroundStudies highlighting the difficulties associated with lithium suggest that the role of antipsychotic drugs and mood stabilisers in bipolar disorder should be reconsidered.AimsTo review the efficacy and mode of action of antipsychotic drugs in mania, and to consider the differences between official guidelines and routine clinical practice in the use of these agents for mania.MethodReview of research, guideline- and practice-based literature.ResultsGuidelines recommend lithium or valproate as first-line treatments for mania, and antipsychotic agents only as ‘adjuncts’ for agitation, dangerous behaviour or psychosis. However, in routine practice, antipsychotic drugs are often prescribed. The effectiveness of these agents in mania has been established by several studies; newer atypical compounds demonstrate antimanic efficacy with a reduced incidence of neurological side-effects.ConclusionAntipsychotic drugs are important in the treatment of bipolar disorder and mania. Future studies should evaluate the long-term efficacy and safety of newer atypical antipsychotic agents, and the place of anticonvulsants in combination with antipsychotics in bipolar disorder.
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Navari, S., and P. Dazzan. "Do antipsychotic drugs affect brain structure? A systematic and critical review of MRI findings." Psychological Medicine 39, no. 11 (April 2, 2009): 1763–77. http://dx.doi.org/10.1017/s0033291709005315.
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BackgroundThe potential effects of antipsychotic drugs on brain structure represent a key factor in understanding neuroanatomical changes in psychosis. This review addresses two issues: (1) do antipsychotic medications induce changes in total or regional human brain volumes and (2) do such effects depend on antipsychotic type?MethodA systematic review of studies reporting structural brain magnetic resonance imaging (MRI) measures: (1) directly in association with antipsychotic use; and (2) in patients receiving lifetime treatment with antipsychotics in comparison with drug-naive patients or healthy controls. We searched Medline and EMBASE databases using the medical subject heading terms: ‘antipsychotics’ AND ‘brain’ AND (MRI NOT functional). The search included studies published up to 31 January 2007. Wherever possible, we reported the effect size of the difference observed.ResultsThirty-three studies met our inclusion criteria. The results suggest that antipsychotics act regionally rather than globally on the brain. These volumetric changes are of a greater magnitude in association with typical than with atypical antipsychotic use. Indeed, there is evidence of a specific effect of antipsychotic type on the basal ganglia, with typicals specifically increasing the volume of these structures. Differential effects of antipsychotic type may also be present on the thalamus and the cortex, but data on these and other brain areas are more equivocal.ConclusionsAntipsychotic treatment potentially contributes to the brain structural changes observed in psychosis. Future research should take into account these potential effects, and use adequate sample sizes, to allow improved interpretation of neuroimaging findings in these disorders.
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M, Jagadeesan, Kiran Kumar R, and Justin Jacob Abraham. "A CASE STUDY ON SCHIZOPHRENIA INDUCED MULTIPLE COMORBIDITIES." Asian Journal of Pharmaceutical and Clinical Research 11, no. 6 (June 7, 2018): 1. http://dx.doi.org/10.22159/ajpcr.2018.v11i6.23979.
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Schizophrenia is a mental disorder characterized by abnormal social behavior which includes false beliefs, confusion, and auditory hallucination. Antipsychotic drugs therapy increases the risk of developing diabetes mellitus and coronary artery disease (CAD) in schizophrenic patients. Hence, we have planned for a systematic approach toward the management of comorbidities induced in schizophrenic patients. A case study was conducted in 42-year-old female patient diagnosed with schizophrenia along with Type-2 diabetes mellitus, hypothyroidism, diabetic retinopathy, diabetic nephropathy, systemic hypertension, CAD-acute coronary syndrome recent inferior wall myocardial infarction. The patient was treated with atypical antipsychotics, antiplatelets, antianginals, statins, hypoglycemic agents, and other supportive measures. The patient improved symptomatically. The antipsychotic treatment for schizophrenia induces abnormal metabolic syndrome which results in decreased glucose and lipid metabolism that leads to obesity, hyperglycemia, and dyslipidemia associated with cardiovascular risks. Often antipsychotics are combined with benzodiazepines and antiparkinson agents to reduce the risks caused from large doses of antipsychotic medication. However, people receiving first-generation antipsychotics have higher prevalence of developing diabetes mellitus and cardiac risks compared to second-generation antipsychotics. Hence, we conclude that atypical antipsychotic drugs such as amisulpride, aripiprazole, and ziprasidone should be given to schizophrenic patients because these drugs have little effects on abnormal metabolic syndrome when compared to other antipsychotics. There is a need for proper screening of blood glucose level and cardiovascular risks assessment before the administration of antipsychotic medications to schizophrenic patients and also during the course of treatment regularly.
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Balant-Gorgia, A. E., and L. Balant. "Antipsychotic Drugs." Clinical Pharmacokinetics 13, no. 2 (August 1987): 65–90. http://dx.doi.org/10.2165/00003088-198713020-00001.
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O'Keane, Veronica, and Anna Maria Meaney. "Antipsychotic Drugs." Journal of Clinical Psychopharmacology 25, no. 1 (February 2005): 26–31. http://dx.doi.org/10.1097/01.jcp.0000150223.31007.e0.
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Kerwin, Robert, and Sarah Osborne. "Antipsychotic Drugs." Medicine 28, no. 4 (2000): 23–27. http://dx.doi.org/10.1383/medc.28.4.23.28378.
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Bateman, D. Nicholas. "Antipsychotic drugs." Medicine 35, no. 11 (November 2007): 594–95. http://dx.doi.org/10.1016/j.mpmed.2007.08.011.
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Bateman, D. Nicholas. "Antipsychotic drugs." Medicine 40, no. 3 (March 2012): 105–6. http://dx.doi.org/10.1016/j.mpmed.2011.12.006.
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Dear, James W., and D. Nicholas Bateman. "Antipsychotic drugs." Medicine 44, no. 3 (March 2016): 143–44. http://dx.doi.org/10.1016/j.mpmed.2015.12.026.
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Munjely, Elza Joy, Bindu Latha Nair R., and Varghese P. Punnoose. "Drug utilization pattern in Schizophrenia." International Journal of Basic & Clinical Pharmacology 8, no. 7 (June 24, 2019): 1572. http://dx.doi.org/10.18203/2319-2003.ijbcp20192652.
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Background: Pharmacotherapy is the mainstay of treatment in schizophrenia. The economic impact of this illness is wide ranging, long lasting and huge. The emergence of newer antipsychotics has changed the prescribing pattern. Purpose of this study is to determine the prescription pattern of antipsychotic drugs and to analyse the drug utilization in patients with schizophrenia based on WHO prescribing indicators.Methods: A descriptive study was conducted for a period of 1-year duration at inpatient Department of Psychiatry of a Government Medical College in Kerala, India among 230 schizophrenic patients. The case sheets of patients meeting inclusion criteria were scrutinised to find out the antipsychotic prescription pattern and drug utilization was analysed using WHO prescribing indicators. Analysis was done using descriptive statistics.Results: Newer antipsychotics (55.2%) were prescribed slightly more in preference to older antipsychotic (44.8%) drugs. Out of the newer drugs prescribed olanzapine (20.9%) was prescribed the most followed by risperidone (18%). Haloperidol (22.9%) was the most frequently prescribed older antipsychotic. Majority (71.3%) of the patients were given more than one antipsychotics during the hospital stay. Trihexyphenidyl (27.9%) was the most frequently co-prescribed drug with antipsychotics. Average number of drugs per encounter was 4.19, 73.4% of the drugs were prescribed in their generic name, 50.4% of the encounters were with an injection prescribed. 44.4%of the drugs were prescribed from the EDL (WHO-19th edition). Average drug cost per encounter was Rs.45.43. Percentage of drug cost spent on injections was 8.44%.Conclusions: Newer antipsychotics were more prescribed for schizophrenia of which olanzapine was the commonest. Newer antipsychotics are preferred because of their propensity to cause less side effects and more efficacy. Study of pattern of drug utilization is useful for measuring the economic impact of drug use among patients thereby facilitating rational prescribing.
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Eka Rusmana, Wempi, and Yuliyanti Yuliyanti. "Profil Peresepan Antipsikosis di Unit Rawat Jalan Rumah Sakit Mitra Keluarga Bekasi Timur Periode April – Mei 2021." Cerdika: Jurnal Ilmiah Indonesia 2, no. 3 (March 25, 2022): 379–83. http://dx.doi.org/10.36418/cerdika.v2i3.357.
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One of the global burdens currently engulfing the world is the COVID-19 pandemic. But before COVID-19 was declared a pandemic by the WHO, the world was struggling with the global burden of mental disorders. WHO states that depression and anxiety are mental disorders with the highest frequency. Mental disorders are one of the health problems that often go unnoticed. To treat mental disorders, antipsychotic therapy is needed which can be obtained at various health facilities, one of which is the Mitra Keluarga Hospital, East Bekasi, which serves patients with mental disorders. Antipsychotics are useful in the therapy of acute and chronic psychosis, a mental disorder such as dreams and imaginary thoughts (hallucinations) and normalize abnormal behavior. The purpose of this study was to determine the profile of antipsychotic prescribing in the pharmacy outpatient unit at Mitra Keluarga Hospital, East Bekasi for the period April – May 2021. This study was conducted using a quantitative descriptive method by taking primary data from doctor's prescriptions containing antipsychotics. The results obtained can see the profile of the most widely used antipsychotic prescribing based on the active substance, drug class, drugs used concurrently with antipsychotic drugs and the most widely used antipsychotic drugs by gender. The final analysis results obtained can assist in the procurement of antipsychotic drugs in health facilities.
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Taylor, David, Corina Young, Raadiyya Esop, Carol Paton, and Rebecca Walwyn. "Testing for diabetes in hospitalised patients prescribed antipsychotic drugs." British Journal of Psychiatry 185, no. 2 (August 2004): 152–56. http://dx.doi.org/10.1192/bjp.185.2.152.
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BackgroundStudies using computer databases suggest that atypical antipsychotic agents are more likely to be associated with diabetes than are conventional drugs.AimsTo discover the extent of testing for diabetes mellitus in hospital in-patients prescribed antipsychotics.MethodPrescription charts were screened to identify patients prescribed antipsychotics. Case notes were then searched for evidence of testing for diabetes.ResultsIn all, 606 patients were prescribed antipsychotics, of whom 250 (41.3%) had evidence of prior testing for diabetes. Patients prescribed atypicals were 40% more likely to have been tested than those prescribed conventional drugs (RR = 1.4, 95% C11.1–1.9). Adjusted odds ratios v. conventional antipsychotics for testing were significantly higher for clozapine (OR = 4.64, 95% C12.42–8.90), olanzapine (OR= 1.85, 95% C11.04–3.30) and antipsychotic polypharmacy (OR= 2.96, 95% C11.59–5.52).ConclusionsTesting for diabetes was undertaken in less than half of the patients studied. Testing was more common in those receiving atypical antipsychotics. Apparent differences in claimed causal association of the use of some antipsychotics with diabetes may in part reflect different rates of testing.
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Suresh, Velumani, J. D. Lakhani, and Ramachandran Balaraman. "A Review on the Possible Therapeutic Intervention by Herbal Remedies on Antipsychotic Drugs Induced Metabolic Disorder." Journal of Natural Remedies 22, no. 1 (February 14, 2022): 13. http://dx.doi.org/10.18311/jnr/2022/28665.
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This review is the compilation of some of the natural products which are effective in treating diabetes, lipid abnormalities and cardiovascular diseases. We also discussed metabolic disorder associated with antipsychotic drugs. Currently, there are no equivocal evidence to demonstrate the effectiveness of herbal drugs in treating metabolic disorders induced by antipsychotic drugs. Therefore, there is a need of extensive research work to be carried out to explore the possibilities of therapeutic intervention of herbal drugs in antipsychotics induced metabolic disorders.
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Barnes, Thomas R. E., and Mike A. McPhillips. "Critical analysis and comparison of the side-effect and safety profiles of the new antipsychotics*." British Journal of Psychiatry 174, S38 (May 1999): 34–43. http://dx.doi.org/10.1192/s0007125000298097.
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The conventional antipsychotic drugs are associated with a wide range of unwanted effects (Barnes & Guy Edwards, 1993; Guy Edwards & Barnes, 1993). These side-effects represent part of the burden of patients given antipsychotic medication, affect compliance with treatment, and contribute to the prescribing clinician's weigh-ing-up of the risks and benefits of a particular antipsychotic in an individual case. The conventional drugs show differences in their side-effect profiles, particularly with regard to sedation and extrapyramidal problems, and it is probably a reasonable generalisation to state that these have largely governed clinicians' choice. The newer ‘atypical’ antipsychotics (such as clozapine, risperidone, sertindole, olanzapine, quetiapine and amisulpride) are less liable to cause extrapyramidal symptoms than the conventional antipsychotics. However, this advantage is greater for some of the new drugs than for others, and their safety profiles also differ in other key respects. Thus, in terms of side-effects and safety, each of these newer drugs must be evaluated individually.
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Bryant, Stephen G., Linda Ann Felthous, and Alan R. Felthous. "Antipsychotic Drugs: Medicolegal Implications for Pharmacists." Journal of Pharmacy Practice 3, no. 4 (August 1990): 276–80. http://dx.doi.org/10.1177/089719009000300409.
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The purposes of this article are to briefly review the adverse reactions induced by antipsychotics that have the greatest modicolegal implications and to set them in the context of pharmacist liability for patient injury. Although little or no case law has evolved specifying antipsychotic drugs and the pharmacist's possible duty to warn, such an obligation may be increasingly realized as standards of practice in psychiatric pharmacy are elevated.
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Dawood, Haider N., and Makki Abdul Kader Al- Hadithi. "QTc Prolongation in Patients on Antipsychotic Drugs." Journal of the Faculty of Medicine Baghdad 55, no. 1 (April 1, 2013): 33–37. http://dx.doi.org/10.32007/jfacmedbagdad.551664.
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Background: There is a recognized association between prolongation of the heart rate corrected QT interval (QTc) and antipsychotic drugs. QTc prolongation may increase the risk of ventricular tachyarrhythmias, especially torsade de pointes, and therefore, sudden cardiac death.
Objective: This study assess the effect of antipsychotics and prolongation of the heart rate corrected QT interval (QTC), and QTC prolongation may increase the risk of ventricular tachyarrhythmias, especially torsade de pointes and sudden cardiac death.
Results: Abnormal QTc was defined as an interval of more than 440 ms (0.44 second) and was present in 21.7% (43 patients of 198). Benzhexol (-0.333 – 0.051 second), Fluphenazine (-0.046 – 0.671) were robust predictors of QTc lengthening, also the high antipsychotic dose and combination of antipsychotics and antidepressants were associated with higher incidence of QTc lengthening.Methods: QT interval measured in lead II in electrocardiogram for 198 patients with psychiatric at Baghdad Teaching Hospital and AL – Rashad Teaching hospital from July to October 2001. Bazett formula was used in calculation of corrected QT. By application of the chi – square test "×2" to see the association of QTc prolongation with the cigarette smoking, age, sex, heart rate, cardiovascular disease.
Conclusion :Antipsychotic drugs cause QTc lengthening in a dose – related manner. Risks are substantially higher for Benzhexol and Fluphenazine. These drugs may therefore confer an increased risk of drugs – induced arrhythmia.
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Kessing, Lars Vedel, Anders Frøkjær Thomsen, Ulla Brasch Mogensen, and Per Kragh Andersen. "Treatment with antipsychotics and the risk of diabetes in clinical practice." British Journal of Psychiatry 197, no. 4 (October 2010): 266–71. http://dx.doi.org/10.1192/bjp.bp.109.076935.
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BackgroundTreatment with antipsychotics seems to increase the risk of developing diabetes but the association is poorly characterised in clinical practice.AimsTo investigate and characterise the incidence of diabetes for people treated with antipsychotic medication in clinical practice.MethodThe study used the linkage of registers of all prescribed antipsychotics, antidiabetics and diagnoses of diabetes in Denmark during a period from 1996 to 2005 and identified all people treated with antipsychotics in Denmark and a random sample of about 30% of the total Danish population.ResultsIn total, 345 937 patients who purchased antipsychotics and 1 426 488 unexposed individuals were included in the study. Among the total population, 50 379 individuals subsequently developed incident diabetes. Compared with unexposed individuals, treatment with first- (rate ratio, RR = 1.53, 95% CI 1.49–1.56) as well as second-generation (RR = 1.32, 95% CI 1.22–1.42) antipsychotics was associated with increased risk of subsequent incident diabetes. The rate of incident diabetes varied substantially between individual second-generation antipsychotic drugs (olanzapine, risperidone clozapine compared with unexposed individuals: low to moderate rate ratio between 1.17 and 1.57; ziprasidone and sertindol: two or more times increased rate ratio; amisulpride, quetiapine and aripiprazole: no significantly increased rate ratio). For both first- and second-generation antipsychotics, the incidence of diabetes increased with the number of prescriptions. Additionally, the incidence of diabetes increased with the number of combined antipsychotic drugs.ConclusionsIn clinical practice, treatment with first- and second-generation antipsychotics is associated with an increased risk of developing incident diabetes with large differences between individual drugs. The risk increases with the duration of treatment and with polypharmacy of antipsychotic drugs.
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Keks, Nicholas A., Kylie Altson, Judy Hope, Natalie Krapivensky, Christine Culhane, Amgad Tanaghow, Peter Doherty, and Anne Bootle. "Use of Antipsychosis and Adjunctive Medications by an Inner Urban Community Psychiatric Service." Australian & New Zealand Journal of Psychiatry 33, no. 6 (December 1999): 896–901. http://dx.doi.org/10.1046/j.1440-1614.1999.00639.x.
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Objective: The aim of this paper is to survey patterns of use of new generation and conventional antipsychosis and adjunctive drugs by an inner urban community psychiatric service. Method: All prescriptions for antipsychosis medications and all patients receiving these drugs in May 1998 were identified. Case record review yielded demographic and diagnostic data. Information was also obtained directly from prescribers. Results: Of 859 patients, 77% received antipsychosis medication; 53% of prescriptions for antipsychotics were for new generation drugs: risperidone (42%), olanzapine (37%) and clozapine (21%). Mean doses were 4.1 ± 2.5 mg (risperidone), 14.7 ± 8.2 mg (olanzapine) and 377.4 ± 178.9 mg (clozapine). Doses for men tended to be higher than those for women, but the differences were not significant. DSM-IV diagnosis was schizophrenia for 74% of patients on atypicals, but patients with other diagnoses were also being treated with these drugs. Risperidone was more commonly used in combination with benzodiazepines and anticholinergics than olanzapine and clozapine, while clozapine was less likely to be combined with antidepressants and mood stabilisers. Of the conventionals, 66% were in depot form, mostly because of non-compliance. Combinations of antipsychotics were prescribed to 13% of patients. Conclusion: New generation antipsychosis medications were prescribed more commonly than conventional drugs in this service for a wide range of diagnoses. Adjunctive medications were commonly utilised. These findings underline the clinical complexity of antipsychotic treatment in a changing environment.
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Truong, Trang T. T., Chiara C. Bortolasci, Srisaiyini Kidnapillai, Briana Spolding, Bruna Panizzutti, Zoe S. J. Liu, Jee Hyun Kim, et al. "Integrative Analyses of Transcriptomes to Explore Common Molecular Effects of Antipsychotic Drugs." International Journal of Molecular Sciences 23, no. 14 (July 6, 2022): 7508. http://dx.doi.org/10.3390/ijms23147508.
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There is little understanding of the underlying molecular mechanism(s) involved in the clinical efficacy of antipsychotics for schizophrenia. This study integrated schizophrenia-associated transcriptional perturbations with antipsychotic-induced gene expression profiles to detect potentially relevant therapeutic targets shared by multiple antipsychotics. Human neuronal-like cells (NT2-N) were treated for 24 h with one of the following antipsychotic drugs: amisulpride, aripiprazole, clozapine, risperidone, or vehicle controls. Drug-induced gene expression patterns were compared to schizophrenia-associated transcriptional data in post-mortem brain tissues. Genes regulated by each of four antipsychotic drugs in the reverse direction to schizophrenia were identified as potential therapeutic-relevant genes. A total of 886 genes were reversely expressed between at least one drug treatment (versus vehicle) and schizophrenia (versus healthy control), in which 218 genes were commonly regulated by all four antipsychotic drugs. The most enriched biological pathways include Wnt signaling and action potential regulation. The protein-protein interaction (PPI) networks found two main clusters having schizophrenia expression quantitative trait loci (eQTL) genes such as PDCD10, ANK2, and AKT3, suggesting further investigation on these genes as potential novel treatment targets.
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Brown, Leigh Anne, and Gary M. Levin. "Sertindole, a New Atypical Antipsychotic for the Treatment of Schizophrenia." Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy 18, no. 1 (January 2, 1998): 69–83. http://dx.doi.org/10.1002/j.1875-9114.1998.tb03829.x.
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The introduction of antipsychotics for the management of schizophrenia greatly improved the quality of life of many patients suffering from this debilitating disease. Although typical antipsychotic drugs represent a significant advancement in psychopharmacology, they carry a heavy side effect burden, have little efficacy in the management of negative symptoms, and are ineffective in about one‐third of patients with schizophrenia. Atypical antipsychotic agents characterized the next major advancement in pharmacotherapy They differ from typical antipsychotics in their mechanism of action, side effect profiles, and clinical efficacy. Sertindole is a new atypical antipsychotic.
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Sicouri, Serge, and Charles Antzelevitch. "Mechanisms Underlying the Actions of Antidepressant and Antipsychotic Drugs That Cause Sudden Cardiac Arrest." Arrhythmia & Electrophysiology Review 7, no. 3 (2018): 199. http://dx.doi.org/10.15420/aer.2018.29.2.
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A number of antipsychotic and antidepressant drugs are known to increase the risk of ventricular arrhythmias and sudden cardiac death. Based largely on a concern over the development of life-threatening arrhythmias, a number of antipsychotic drugs have been temporarily or permanently withdrawn from the market or their use restricted. While many antidepressants and antipsychotics have been linked to QT prolongation and the development of torsade de pointes arrhythmias, some have been associated with a Brugada syndrome phenotype and the development of polymorphic ventricular arrhythmias. This article examines the arrhythmic liability of antipsychotic and antidepressant drugs capable of inducing long QT and/or Brugada syndrome phenotypes. The goal of this article is to provide an update on the ionic and cellular mechanisms thought to be involved in, and the genetic and environmental factors that predispose to, the development of cardiac arrhythmias and sudden cardiac death among patients taking antidepressant and antipsychotic drugs that are in clinical use.
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Loga-Zec, Svjetlana, Irfan Zulić, Nedžad Mulabegović, Slobodan Loga, Saida Fišeković, and Jasna Kusturica. "Models of treatment with antipsychotics of the schizophrenic patients." Bosnian Journal of Basic Medical Sciences 5, no. 4 (November 20, 2005): 78–83. http://dx.doi.org/10.17305/bjbms.2005.3238.
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The aim of this study were to determine which antipsychotic are currently in use, to establish which doses are administrated to patients, to find out is there a practice of proscribing simultaneously more then one antipsychotic drug, to determine whether antipsychotic are proscribed in divided doses, to establish whether there is, besides antipsychotics, treatment with other medicaments (co-administration), especially with antiparkinsonics. The research (study) is epidemiological-clinical prospective, descriptive and analytical and it was conducted at University hospitals in Sarajevo, Tuzla and Mostar. Criteria for inclusion, non-inclusion and exclusion from the study were precisely defined as a mean for formation of sample. Based on this hypothesis were established, zero and alterative. According to zero hypothesis in the treatment of schizophrenia at University hospitals in FBiH new antipsychotic drugs are in use, small doses are proscribed (up to 20 mg), not more then one antipsychotic drug is used simultaneously, antipsychotics are administrated once a day and alongside with antipsychotics other medicaments are not co-administrated, especially antiparkinsons. The results of our study are showing that majority of patients are treated with classical antipsychotics. Minority of patients is treated with atypical neuroleptics like olanzapine, which is proscribed only in Sarajevo. Use of risperidone and ziprasidone is registered also only in Sarajevo, but only small number of patients is treated with these drugs. Most frequent antipsychotics were promazine and haloperidol. The range between minimal and maximal daily dose of promazine was from 50 to 450 mg/daily, and for haloperidol from 1 to 75 mg/daily. Above-mentioned drugs were administrated in an average from two to three times a day. Alongside with antipsychotics, other drugs were used. Most frequent was the use of biperidine in oral and parenteral formulation, as well as nitrazepam and diazepam. The importance of this study is following: data are useful for the current mental health care reform in FBiH, results will point out place and position of FBiH in contemporary world trends in the treatment of schizophrenia, they will contribute to rational use of antipsychotic therapy, they will point out possible ways in reduction of side effects, often dangerous adverse effects of antipsychotics, and they will give contribution to faster rehabilitation of schizophrenics with the reduction of financial means for the treatment of patients with schizophrenia.
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Tamminga, Ca. "The Promise of New Drugs for Schizophrenia Treatment." Canadian Journal of Psychiatry 42, no. 3 (April 1997): 265–73. http://dx.doi.org/10.1177/070674379704200304.
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Objective To present aspects of preclinical and clinical pharmacology of new antipsychotic drugs and to emphasize those preclinical drug characteristics which might predict desirable clinical actions. Method Review of the relevant literature and publicly presented data. Results Traditional neuroleptics have considerable effectiveness in treating positive symptoms of psychosis but can cause serious motor side effects. Clozapine produces no motor side effects and delivers a unique antipsychotic action. Risperidone also produces low motor side effects, but only at relatively low doses. Olanzapine and sertindole are newly introduced. Both have potent antipsychotic actions, with greatly reduced motor side effects. Both drugs also have possible advantages in negative symptoms. Conclusions These data support the conclusion that several new antipsychotics are becoming available for general use which are safe and effective in the treatment of psychosis and have several advantages over traditional neuroleptics.
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Seifert, Randall D. "Therapeutic Drug Monitoring: Psychotropic Drugs." Journal of Pharmacy Practice 2, no. 6 (December 1989): 403–15. http://dx.doi.org/10.1177/089719008900200609.
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The therapeutic monitoring of patients who take antipsychotic drugs can be both challenging and rewarding. Antipsychotics have been in clinical use for over 30 years; yet, their complex pharmacology is not fully understood and parallels our infant knowledge of human brain chemistry. The art of successful therapeutic drug monitoring depends on the clinician's knowledge of basic pharmacology, an understanding of psychiatric disorders, and a sensitivity for careful patient observation. In addition, a thorough history, well thought out goals, and reasonable recovery expectations are essential. Antipsychotic drugs are never curative and should be used judiciously for indications where positive results outweigh the risks of adverse effects. This article will provide the reader with sound, practical knowledge of how to monitor these drugs in any clinical setting. © 1989 by W.B. Saunders Company.
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Balashova, A. V., D. V. Mamleeva, L. V. Machekhina, and E. N. Dudinskaya. "Metabolic adverse effects of antipsychotics: the state of the problem and management options." Obesity and metabolism 19, no. 4 (February 27, 2023): 431–41. http://dx.doi.org/10.14341/omet12935.
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Antipsychotic drugs are widely used for many psychiatric disorders, such as schizophrenia, bipolar affective disorder, delusions and hallucinations due to neurological disorders, depression with severe psychotic symptoms. Metabolic disorders including weight gain, dyslipidemia and hyperglycemia are one of the most common side effects of antipsychotic therapy. Psychiatric patients have higher risk of cardiovascular disease, so that the development of metabolic side effects is an important clinical problem that should be solved. Antipsychotic-induced weight gain may cause distress that leads to antipsychotics withdraw and repeated hospitalizations.Lifestyle changes, correction of the antipsychotic treatment, additional medications and their combination are the possible solutions of antipsychotic metabolic side effects. Lifestyle modification is a first-line therapy that should complement other options, when it feasible. At the same time, it can be extremely difficult for patients receiving antipsychotic to adhere dietary and physical activity recommendations. Replacing an antipsychotic with a milder drug is not always possible and may not be enough effective. Metformin seems to be the most well-studied, safe and effective agent that is prescribed to deal with antipsychotic-induced weight gain and associated metabolic disorders. Glucagon-like peptide type 1 receptor agonists and thiazolidinediones are mentioned as alternative medications, but clinical data on their efficacy and safety in this patient group are extremely limited. Dyslipidemia can develop as an independent antipsychotic side effect even without an increase in body weight. The most effective treatment, as in the general population, is statin therapy. However, the joint appointment of statins and antipsychotic significantly increases the risk of adverse reactions, such as myalgia, myopathy, increased creatine kinase levels, due to the competition of drugs for the cytochrome system.It is still unknown what scales should be used for cardiovascular risk stratification in patients taking antipsychotic and whether it is possible to use metformin to prevent antipsychotic-induced weight gain, and if so, how to select patients for whom such therapy can be indicated. Finally, more clinical trials are needed to evaluate the efficacy and safety of other classes of hypoglycemic and lipid-lowering drugs in patients on antipsychotics.
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SINGH, K. P., and NIDHI TRIPATHI. "ANTIPSYCHOTIC MEDICATION DURING PREGNANCY AND POSSIBLE BIRTH DEFECTS." Scientific Temper 2, no. 1&2 (July 25, 2011): 89–100. http://dx.doi.org/10.58414/scientifictemper.2011.02.1.17.
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Antipsychotics drugs like chlorpromazine, haloperidol, clozapine, risperidone, olanzapine and many other are commonly used in psychiatric medicine. Approximately one third of pregnant women with psychotic symptoms use antipsychotics at least once. Although adequate and well-controlled studies have not been done in any one of these antipsychotic drugs, animal studies have revealed evidence of teratogenic or embryo/fetotoxic effects in all of them. Use of typical drugs like chlorpromazine and haloperidol shows congenital malformations like skeletal malformations, central nervous system (CNS) defects, cleft palate, cardiac abnormalities, decreased fetal growth, and fetal death. The extrapyramidal symptoms and respiratory distress in infants born to mothers treated with these medications is also reported. Effects of antipsychotic use in lactating mothers are mostly unknown. With increase in the use of newer psychotropics, there is a growing concern in relation to the teratogenicity. As, it is not possible to carry out prospective studies in pregnant women and as a result physicians caring for such patients have to rely on case reports, case series, and retrospective studies. Available evidence shows that the safety of these drugs in pregnancy is still unresolved and the decision to prescribe antipsychotic drugs in pregnancy should be taken in the light of severity of mental disease and drugs should be prescribed only when the potential risk to the foetus from exposure is outweighed by the risk of untreated maternal disorder. In this review we discussed the current evidence of the teratogenic risks antipsychotic drugs commonly used to treat psychiatric disorders
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Leucht, Stefan, and John M. Davis. "Do antipsychotic drugs lose their efficacy for relapse prevention over time?" British Journal of Psychiatry 211, no. 3 (September 2017): 127–29. http://dx.doi.org/10.1192/bjp.bp.117.201103.
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SummaryThere is a debate about long-term treatment of schizophrenia with antipsychotic drugs, with some experts suggesting that these drugs should be discontinued. In this issue, Takeuchi et al demonstrated by a meta-analysis of 11 trials that antipsychotic drugs maintained their efficacy for relapse prevention for 1 year, whereas patients on placebo kept getting worse. We consider these findings in the light of the current discussion about possible dose-related brain volume loss, supersensitivity psychosis, the high variability of results in long-term follow-up studies and recent approaches to discontinue antipsychotics in patients with a first-episode. The new findings speak in favour of continuing antipsychotics at the same dose, at least in patients whose condition is chronic, but the topic is complex.
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Abid, W., F. Chérif, N. Bouattour, R. Masmoudi, F. Guermazi, I. Feki, R. Sallemi, and J. Masmoudi. "Thrombotic complications of treatment with antipsychotic drugs : risk factors." European Psychiatry 66, S1 (March 2023): S590. http://dx.doi.org/10.1192/j.eurpsy.2023.1234.
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IntroductionAntipsychotic agents (AP) are widely used drugs to treat psychotic symptoms. For decades, some studies suggested that there is a relationship between using (AP) and the risk of venous thromboembolism (VTE) and pulmonary embolism (PE). The causality of this association, its risk factors, and its implications for clinical practice have not been fully elucidated.ObjectivesWe undertook a systematic literature review to evaluate the evidence for an association between antipsychotic medication and venous thromboembolic events (VTE) and to identify risk factors for these adverse effects.MethodsTo identify relevant studies, we searched the PubMed, Science Direct databases up using the following keywords « pulmonary embolism », « venous thromboembolism » « antipsychotics agents ». We also searched the reference lists relevant articles for related studies.ResultsTwelve articles are included in this analysis and indicate an elevated risk of VTE in antipsychotic drug users. The results showed that compared with non-users, current AP users have significantly increased risks of VTE. The risk of venous thrombosis in obese people was higher than that in overweight people, patients not less than 65 years old had an increased risk compared with younger patients . In addition, women taking antipsychotics had a higher risk of pulmonary embolism than men. The other factors that increased risk were use of second-generation antipsychotics and antipsychotic polytherapy. The highest risk was noted in the first 3 months of treatment. Data also suggested a dose-dependent increase in the risk of thrombotic complications. For individual drugs, increased risk of VTE and PE was observed in taking clozapine , haloperidol, risperidone and olanzapine. Clozapine was associated with the highest risk. However, careful interpretation is needed because of high heterogeneity among studies and scarce data.ConclusionsThe use of antipsychotics will increase the risk of venous thromboembolism and pulmonary embolism, which will be affected by AP and patient characteristics.Disclosure of InterestNone Declared
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Slaveska, Karmen, Chris Hollis, and David Bramble. "Use of antipsychotics by child and adolescent psychiatrists." Psychiatric Bulletin 22, no. 11 (November 1998): 685–87. http://dx.doi.org/10.1192/pb.22.11.685.
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Aims and methodsA postal questionnaire of Trent Region's consultant child and adolescent psychiatrists was used to investigate the two-year period prevalence rates of antipsychotic medication prescription, and the ICD–10 psychiatric disorders it was used to treat.ResultsThe response rate was good (92.3%) and 78% of respondents had prescribed antipsychotic medication for a range of conditions over the period, albeit very infrequently. Antipsychotics were used for a range of psychotic and non-psychotic disorders. The older antipsychotic agents (thioridazine, chlorpromazine and haloperidol) comprised the bulk of prescriptions. Newer, atypical, antipsychotics were prescribed only four times over the period and no patients in residential in-patient units received this form of treatment.Clinical implicationsThese results highlight a pressing need to address antipsychotic prescribing in children and adolescents and, especially, the role of new antipsychotic drugs.
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Kane, John M. "Newer Antipsychotic Drugs." Drugs 46, no. 4 (October 1993): 585–93. http://dx.doi.org/10.2165/00003495-199346040-00002.
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Davis, John M., Leor Metalon, Mark D. Watanabe, and Lesley Blake. "Depot Antipsychotic Drugs." Drugs 47, no. 5 (May 1994): 741–73. http://dx.doi.org/10.2165/00003495-199447050-00004.
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Shader, Richard I. "Novel Antipsychotic Drugs." Journal of Clinical Psychopharmacology 13, no. 1 (February 1993): 83. http://dx.doi.org/10.1097/00004714-199302000-00022.
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Ballenger, J. C. "Atypical antipsychotic drugs." Yearbook of Psychiatry and Applied Mental Health 2012 (January 2012): 337–40. http://dx.doi.org/10.1016/j.ypsy.2011.07.103.
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Leonard, B. E. "Novel antipsychotic drugs." Neurochemistry International 22, no. 6 (June 1993): 599. http://dx.doi.org/10.1016/0197-0186(93)90035-4.
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