Revista de Psiquiatría y Salud Mental (English Edition)最新文献

{"title":"Valproate, obesity and other causes of clozapine poor metabolism in the context of rapid titration may explain clozapine-induced myocarditis: A re-analysis of a Turkish case series","authors":"Aygün Ertuğrul ,&nbsp;A. Elif Anıl Yağcıoğlu ,&nbsp;Esen Ağaoğlu ,&nbsp;Ahmet Alp Karakaşlı ,&nbsp;Sertaç Ak ,&nbsp;M. Kâzım Yazıcı ,&nbsp;Jose de Leon","doi":"10.1016/j.rpsmen.2021.10.001","DOIUrl":"10.1016/j.rpsmen.2021.10.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Clozapine-induced myocarditis or any clozapine-induced inflammation may be a hypersensitivity reaction due to titration that was too rapid for the patient's clozapine metabolism. Clozapine metabolism is influenced by ancestry, sex, smoking and the presence of confounders including obesity, infections, and inhibitors (e.g., valproate) causing the patient to behave as a clozapine poor metabolizer (PM). A published study in a Turkish hospital identified 1 case of clozapine-induced pancreatitis and hepatitis and 9 cases of clozapine-induced myocarditis. To explore the hypothesis that the 10 patients were clozapine PMs, their serum clozapine concentrations were investigated using concentration-to-dose (C/D) ratios and their titrations carefully reviewed.</p></div><div><h3>Methods</h3><p>Dividing the trough serum concentration by the dose produces the clozapine C/D ratio. The dose required to reach 350<!--> <!-->ng/ml was considered the minimum therapeutic dosage and was used to classify patients according to clozapine PM status. Titration speed was assessed.</p></div><div><h3>Results</h3><p>All 10 patients were possibly clozapine PMs (3 of them had as minimum therapeutic doses: 72, 82 or 83<!--> <!-->mg/day). Nine of the 10 patients may have behaved as clozapine PMs due to obesity and/or valproate co-prescription during titration. One also had an undiagnosed infection. Of the 10 patients, 9 had at least 1 of 3 factors: too-rapid titration in the first or second weeks, or a final dosage that was too high.</p></div><div><h3>Conclusions</h3><p>Future studies using clozapine levels and considering the role of clozapine PM status should explore whether or not all cases of clozapine-induced inflammation could be explained by lack of individualized titration.</p></div>","PeriodicalId":101104,"journal":{"name":"Revista de Psiquiatría y Salud Mental (English Edition)","volume":"15 4","pages":"Pages 281-286"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10825227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic stability in substance-induced psychosis","authors":"Lucía Inchausti ,&nbsp;Iñigo Gorostiza ,&nbsp;Miguel Angel Gonzalez Torres ,&nbsp;Rodrigo Oraa","doi":"10.1016/j.rpsmen.2019.10.006","DOIUrl":"10.1016/j.rpsmen.2019.10.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Substance-induced psychosis (SIP) is the name given to a psychosis that starts in the context of substance abuse but persists for days and weeks with no substance use. There is as yet little knowledge about the longitudinal course of this psychosis, which suggests that significant numbers go on to be diagnosed with a severe mental disorder (SMD). The objective of this study was to analyse the progression of SIP to SMD in our environment and the possible factors that may be involved in that conversion.</p></div><div><h3>Material and Methods</h3><p><span>We used a retrospective cohort follow-up design. We reviewed all diagnoses of patients discharged from the psychiatric hospitalisation unit of the University Hospital of Basurto from January 2002 to December 2015 inclusively. In addition to sociodemographic and clinical data, information was collected on the consumption of cannabinoids, opioids, </span>amphetamines<span>, cocaine and alcohol. The data were analysed using descriptive analysis, Kaplan-Meier survival curves and Cox regression.</span></p></div><div><h3>Results</h3><p>Of the 116 patients, 78.4% were male, had an average age of 33.0 (SD = 8.9) years and 44.0% were single; 31.0% had a psychiatric family history; the most commonly used substance was cannabis (60.3%), followed by cocaine (40.5%). The cumulative risk of diagnostic conversion to an SMD in 16 years was 41.6% (95%CI: 32.2–52.2) over a mean 36.43 months.</p></div><div><h3>Conclusions</h3><p>In interventions in episodes of SIP we must bear in mind that a significant proportion will progress to an SMD in the first three years.</p></div>","PeriodicalId":101104,"journal":{"name":"Revista de Psiquiatría y Salud Mental (English Edition)","volume":"15 4","pages":"Pages 272-280"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10335619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different measures for auditory hallucinations in populations with psychosis. The Validation of the Spanish versions of the Auditory Vocal Hallucination Rating Scale (AVHRS) and the Positive and Useful Voices Inquiry (PUVI)","authors":"Esther Lorente-Rovira ,&nbsp;Eva Grasa ,&nbsp;Susana Ochoa ,&nbsp;Iluminada Corripio ,&nbsp;Trinidad Peláez ,&nbsp;Raquel López-Carrilero ,&nbsp;Ángela Gutiérrez-Gea ,&nbsp;María Morano-Guillén ,&nbsp;José M. Villagrán ,&nbsp;Agna A. Bartels-Velthuis ,&nbsp;Jack A. Jenner ,&nbsp;Julio Sanjuán","doi":"10.1016/j.rpsmen.2020.03.002","DOIUrl":"10.1016/j.rpsmen.2020.03.002","url":null,"abstract":"<div><h3>Introduction</h3><p>An updated summary of the most used instruments assessing auditory hallucinations in population with psychosis, allows us to underline the scarceness and need of Spanish versions of important instruments. The aim of the study is to examine the psychometric characteristics of two different and complementary instruments for assessing auditory hallucinations, the Spanish version of the Auditory Vocal Hallucination Scale (AVHRS) and the Spanish version of the Positive and Useful Voices Inquiry (PUVI).</p></div><div><h3>Materials and methods</h3><p>A sample of 68 patients from four different centres, with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder presenting with auditory hallucinations were included. Apart from the AVHRS and the PUVI, the Psychotic Symptom Rating Scales-Auditory Hallucinations subscale (PSYRATS-AH) and the Positive and Negative Syndrome Scale (PANSS) were also administered to all patients, plus an acceptability questionnaire.</p></div><div><h3>Results</h3><p>The Spanish version of the AVHRS showed a good internal consistency, a moderate to high inter-rater reliability, a medium to moderate test–retest reliability, and a good convergent and discriminant validity. The Spanish version of the PUVI showed a good internal consistency and a heterogeneous, but in general moderate, test–retest reliability.</p></div><div><h3>Conclusions</h3><p>The Spanish versions of the AVHRS and the PUVI have good psychometric properties and are well accepted among patients.</p></div>","PeriodicalId":101104,"journal":{"name":"Revista de Psiquiatría y Salud Mental (English Edition)","volume":"15 4","pages":"Pages 259-271"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10406695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clozapine's uncharted voyage: Five years and a pandemic after the end of mandatory haematological notifications to the Spanish medicines agency","authors":"Pilar Andres-Olivera ,&nbsp;Concha Turrion ,&nbsp;Emilio Fernandez-Egea ,&nbsp;Jesus Perez","doi":"10.1016/j.rpsmen.2022.04.001","DOIUrl":"10.1016/j.rpsmen.2022.04.001","url":null,"abstract":"","PeriodicalId":101104,"journal":{"name":"Revista de Psiquiatría y Salud Mental (English Edition)","volume":"15 4","pages":"Pages 293-294"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10659331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clozapine for the treatment of pediatric encephalopathy associated with nonketotic hyperglycinemia","authors":"Sara Jiménez-Fernández ,&nbsp;Manuel Gurpegui ,&nbsp;Jose de Leon ,&nbsp;Luis Gutiérrez-Rojas","doi":"10.1016/j.rpsmen.2022.10.001","DOIUrl":"10.1016/j.rpsmen.2022.10.001","url":null,"abstract":"","PeriodicalId":101104,"journal":{"name":"Revista de Psiquiatría y Salud Mental (English Edition)","volume":"15 4","pages":"Pages 287-289"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10659332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clozapine-associated myocarditis in the World Health Organization's pharmacovigilance database: Focus on reports from various countries","authors":"Carlos De las Cuevas ,&nbsp;Emilio J. Sanz ,&nbsp;Can-Jun Ruan ,&nbsp;Jose de Leon","doi":"10.1016/j.rpsmen.2021.07.005","DOIUrl":"10.1016/j.rpsmen.2021.07.005","url":null,"abstract":"<div><h3>Introduction</h3><p>The incidence of clozapine-associated myocarditis varies by country. These variations were explored in VigiBase, the World Health Organization's global database which has &gt;25 million spontaneously reported adverse drug reaction (ADR) reports from 145 national drug agencies.</p></div><div><h3>Methods</h3><p>On January 15, 2021, a search of VigiBase since inception focused on myocarditis in clozapine patients. The 3572 individual reports were studied using the standard VigiBase logarithmic measure of disproportionality called information component (IC). The IC measures the disproportionality between the expected and the reported rates. After duplicates were eliminated there were 3274 different patients with myocarditis studied in logistic regression models.</p></div><div><h3>Results</h3><p>The first case was published in 1980 but since 1993 the VigiBase clozapine-myocarditis IC has been significant; moreover, currently it is very strong (IC<!--> <!-->=<!--> <!-->6.0, IC₀₀₅–IC₉₉₅ <!-->=<!--> <!-->5.9–6.1) and statistically significantly different from other antipsychotics. Of the 3274 different patients with myocarditis, 43.4% were non-serious cases, 51.8% were serious but non-fatal, and 4.8% were fatal. More than half (1621/3274) of the reports came from Australia, of which 69.2% were non-serious, 27.7% serious but non-fatal, and 3.1% fatal. Asian countries contributed only 41 cases.</p></div><div><h3>Conclusions</h3><p>In pharmacovigilance studies, confounding factors may explain statistical associations, but the strength and robustness of these results are compatible with the hypothesis that myocarditis is definitively associated with early clozapine treatment (84% [1309/1560] and 5% [82/1560] in the first and second months). Myocarditis reports from Australia are over-represented to a major degree. Asian countries may be underreporting myocarditis to their drug agencies.</p></div>","PeriodicalId":101104,"journal":{"name":"Revista de Psiquiatría y Salud Mental (English Edition)","volume":"15 4","pages":"Pages 238-250"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10346075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clozapine-induced myocarditis in Russia: Animal studies but no clinical studies","authors":"Oleg O. Kirilochev ,&nbsp;Carlos De las Cuevas ,&nbsp;Jose de Leon","doi":"10.1016/j.rpsmen.2021.09.001","DOIUrl":"10.1016/j.rpsmen.2021.09.001","url":null,"abstract":"","PeriodicalId":101104,"journal":{"name":"Revista de Psiquiatría y Salud Mental (English Edition)","volume":"15 4","pages":"Pages 294-295"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10443547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Covid-19 outbreak in a Spanish long-term psychiatric hospital led to infections in 6 clozapine patients: elevations in their plasma clozapine levels","authors":"Manuel Arrojo-Romero ,&nbsp;Maria Rosario Codesido-Barcala ,&nbsp;Jose de Leon","doi":"10.1016/j.rpsmen.2022.06.010","DOIUrl":"10.1016/j.rpsmen.2022.06.010","url":null,"abstract":"","PeriodicalId":101104,"journal":{"name":"Revista de Psiquiatría y Salud Mental (English Edition)","volume":"15 4","pages":"Pages 290-292"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9734288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9291348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Here we go again! Subtyping diagnosis and refining treatments","authors":"Javier Vázquez-Bourgon","doi":"10.1016/j.rpsmen.2022.11.001","DOIUrl":"10.1016/j.rpsmen.2022.11.001","url":null,"abstract":"","PeriodicalId":101104,"journal":{"name":"Revista de Psiquiatría y Salud Mental (English Edition)","volume":"15 4","pages":"Pages 221-222"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10443546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dried Blood Spot (DBS) as a useful tool to improve clozapine, aripiprazole and paliperidone treatment: From adherence to efficiency","authors":"Miguel Bernardo ,&nbsp;Gisela Mezquida ,&nbsp;Paula Ferré ,&nbsp;Bibiana Cabrera ,&nbsp;Mercè Torra ,&nbsp;Ana Maria Lizana ,&nbsp;Mercè Brunet","doi":"10.1016/j.rpsmen.2022.04.002","DOIUrl":"10.1016/j.rpsmen.2022.04.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Therapeutic Drug Monitoring<span> (TDM) of antipsychotics in schizophrenia is a powerful tool that allows tailoring the treatment in an individualized approach. Our goals are to develop and validate a Dried Blood Spot (DBS) method for monitoring some commonly used antipsychotics (aripiprazole, clozapine, and paliperidone) and to evaluate its usefulness as a compliance biomarker, as well as in drug-dose adjustment to personalize the antipsychotic treatment to improve its efficacy and safety.</span></p></div><div><h3>Methods</h3><p>31 first-psychotic episode (FEP) and schizophrenia patients were included; 5 refer to naïve FEP who started antipsychotic treatment; 26, to patients with more than one episode and under antipsychotic treatment: aripiprazole (7 cases), clozapine (17), paliperidone (11). For DBS sample collection, 25<!--> <!-->μl of capillary blood were placed in the spot of a FTA™DMPK-C-card. After completely dryness, antipsychotics were extracted and analyzed by a validated UHPLC-MS/MS-method. DBS antipsychotic results were compared with those obtained in venous blood/plasma.</p></div><div><h3>Results</h3><p>Aripiprazole, paliperidone and clozapine showed from good to excellent correlations between concentrations in venous blood and DBS capillary blood (<em>r</em>², from 0.500 to 0.721). The correlation between conventional plasma and DBS concentrations for paliperidone, aripiprazole, clozapine, and their metabolites were moderate, suggesting that optimal drug target concentrations should be established for DBS.</p></div><div><h3>Conclusions</h3><p>In this study, for aripiprazole, dehydroaripiprazole, paliperidone, clozapine and desmethylclozapine, DBS has provided good analytical performance for TDM. Thus, DBS sampling can offer a great alternative over conventional sampling for plasma measurement. The assay provides good analytical performances for TDM and clinical research applicability, suggesting that DBS is a promising clinical application in TDM in psychiatry.</p></div>","PeriodicalId":101104,"journal":{"name":"Revista de Psiquiatría y Salud Mental (English Edition)","volume":"15 4","pages":"Pages 230-237"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10346076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}