Clinical Psychopharmacology and Neuroscience最新文献

{"title":"Psychological Impact of <i>BRCA</i> Genetic Testing: Analysis of Positive and Negative Affect Changes according to Test Results.","authors":"Gyul Jung, Soo Young Hur, Sheng-Min Wang, Youn Jin Choi","doi":"10.9758/cpn.25.1383","DOIUrl":"10.9758/cpn.25.1383","url":null,"abstract":"<p><strong>Objective: </strong><i>BRCA1/2</i> genetic testing may provoke complex emotional reactions that extend beyond simple relief or distress. This study examined affective changes before and after testing and identified demographic, clinical, and familial factors associated with these responses using overall and facet-level scores from the Positive and Negative Affect Schedule (PANAS).</p><p><strong>Methods: </strong>A total of 640 individuals undergoing <i>BRCA1/2</i> testing were enrolled between 2018 and 2025; 392 with complete pre- and post-test PANAS data were included. Changes in affect were modeled according to test result (positive versus negative/variant of uncertain significance [VUS]), age, menopausal status, personal cancer history, and family cancer history. Facet-level analyses explored discrete emotions.</p><p><strong>Results: </strong>Distinct affective patterns were observed. Among 41 to 60-year-olds, positive affect decreased in <i>BRCA</i>-negative/VUS participants, whereas negative affect increased in <i>BRCA</i>-positive individuals. Postmenopausal women and participants with a cancer history who received negative/VUS results showed reduced positive affect. In contrast, <i>BRCA</i>-positive individuals with cancer histories exhibited increases in both positive and negative affect. Absence of family cancer history was linked to reduced positive affect after negative/VUS results. Facet analyses showed diminished self-assurance and greater guilt in negative/VUS participants, and heightened fear, hostility, guilt, and distress in <i>BRCA</i>-positive individuals.</p><p><strong>Conclusion: </strong><i>BRCA</i> testing elicits heterogeneous emotional responses shaped by test results, cancer history, and demographic and familial factors. Facet-level analysis revealed nuanced shifts in discrete emotions-such as decreased self-assurance in non-carriers and heightened fear and guilt in carriers-highlighting the need for tailored, culturally informed genetic counseling, while acknowledging that these findings reflect short-term affective responses and result-related uncertainty.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 3","pages":"589-596"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurovascular Actions of Dipeptidyl Peptidase-4 Inhibitors and Their Implications for Cognitive Dysfunction in Type 2 Diabetes Mellitus.","authors":"Aseel H Mohammad, Shatha H Mohammad, Mohammad H Alsaaty","doi":"10.9758/cpn.26.1403","DOIUrl":"10.9758/cpn.26.1403","url":null,"abstract":"<p><p>Type 2 diabetes mellitus is a major contributor to cognitive dysfunction and neurodegeneration, driven by complex metabolic, vascular, and inflammatory disturbances. Although conventional antidiabetic therapies primarily focus on glycemic control, few effectively preserve the integrity of the neurovascular unit (NVU), a critical determinant of brain health. This review examines the neuroprotective potential of dipeptidyl peptidase-4 (DPP-4) inhibitors, highlighting their unique ability to link metabolic regulation with neural and vascular preservation. A literature search was conducted in PubMed and Google Scholar for English-language articles published up to December 2025, using keywords related to cognitive dysfunction, DPP-4 inhibitors, incretins, glucagon-like peptide-1, and the nervous system. Eligible studies included original research, randomized trials, meta-analyses, animal studies, reviews, and mechanistic investigations addressing the effects of DPP-4 inhibitors on NVU stability. Editorials and studies lacking relevance to diabetes-related cognitive impairment or clear biological mechanisms were excluded. Evidence indicates that DPP-4 inhibitors exert dual neuroprotective actions by enhancing incretin signaling (GLP-1/GIP), which supports synaptic plasticity and attenuates neuroinflammation, and by preserving stromal cell-derived factor-1α, thereby activating the CXCR4 pathway to promote endothelial repair. Additional benefits include modulation of the Nrf2/GPX4 axis, reducing oxidative stress and ferroptosis in neural tissue. Comparative analyses suggest potential advantages over other antidiabetic classes, although clinical data on dementia risk remain heterogeneous. Overall, DPP-4 inhibitors emerge as promising agents for stabilizing the NVU beyond glucose lowering, supporting their repositioning in the management of diabetes-associated cognitive dysfunction.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 3","pages":"480-489"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose-related Manic Switch with Psychotic Features Following Bupropion Titration: A Case Report.","authors":"Rıza Gökçer Tulacı, Sema Yıldırım, Hilal Ulusoy, Nazan Dolapoğlu","doi":"10.9758/cpn.26.1402","DOIUrl":"10.9758/cpn.26.1402","url":null,"abstract":"<p><p>Bupropion is an antidepressant commonly considered to have a relatively low risk of inducing manic switch in the treatment of bipolar depression. However, in certain cases-particularly at higher doses and in the presence of psychotic features-manic switching may occur. In this report, we present a male patient with bipolar I disorder who developed a psychotic manic episode following an increase in bupropion XL dose from 150 mg to 300 mg/day while receiving lithium treatment. This case highlights that, despite its reputation as a relatively safe antidepressant in bipolar depression, bupropion may precipitate dose-related manic and psychotic switches. Based on the clinical findings observed in this patient, cautious dose titration beyond 150 mg/day may be considered in individuals with bipolar disorder with psychotic features, with particular attention to close clinical monitoring following any dose escalation.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 3","pages":"661-664"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Claims Data-Based Comparison of Treatment Continuation between Aripiprazole Once-monthly and Paliperidone Palmitate in Routine Practice.","authors":"Chi-Un Pae, So Hyeon Gwon, Hayeon Kim, Changsu Han, Ashwin A Patkar, Prakash S Masand, Nak-Hoon Son","doi":"10.9758/cpn.26.1446","DOIUrl":"10.9758/cpn.26.1446","url":null,"abstract":"<p><strong>Objective: </strong>Aripiprazole once-monthly (AOM) and paliperidone palmitate once-monthly (PP1M) are commonly used long-acting injectable APs (LAIs) in routine practice. However, their distinct pharmacological properties may differentially influence on long-term treatment continuation. To date, comparison data on long-term treatment continuation between AOM and PP1M are limited.</p><p><strong>Methods: </strong>Patients with schizophrenia spectrum disorders identified from the Korean Health Insurance Review and Assessment Service claims database were followed for 12 months after initiating AOM or PP1M. Cox proportional hazards and Kaplan-Meier analyses were used to assess discontinuation risk and rates.</p><p><strong>Results: </strong>There were significant differences in the discontinuation risk and rates at 6 months (HR = 1.301, 95% CI = 1.242-1.363 and 45.5% vs. 56.2%, respectively) and 12 months (HR = 1.322, 95% CI = 1.270-1.376 and 62.7% vs. 74.1%, respectively) between the two LAIs, where the patients treated with AOM showed lower discontinuation rates than those treated with PP1M. The all-cause hospitalization rates (52.3% vs 60.4%; 53.7% vs 61.6%) and newly developed extrapyramidal symptoms (6.2% vs 7.0%; 7.7% vs. 8.1%) at 6 months and 12 months were numerically lower in AOM than in PP1M, respectively. These findings were consistent in PSM and 3-month landmark analysis.</p><p><strong>Conclusion: </strong>In this nationwide real-world study, AOM was associated with a lower risk of treatment discontinuation than PP1M over 12 months. These findings suggest differences in treatment continuation between the two LAIs and warrant confirmation in studies using more robust designs and diverse clinical data.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 3","pages":"627-640"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational Stress in the Neuroticism-Burnout Link: An Exploratory Examination of Physiological Contributions.","authors":"Hyun Seo Lee, Taegyeong Lee, Koomin Kwon, Woo-Seok Ahn, Seung-Hwan Lee","doi":"10.9758/cpn.25.1377","DOIUrl":"10.9758/cpn.25.1377","url":null,"abstract":"<p><strong>Objective: </strong>Burnout is a debilitating consequence of chronic occupational stress, yet few studies have simultaneously examined its psychological and physiological correlates. This study tested a mediation model linking neuroticism to burnout, with perceived stress as the primary mediator and wearable-derived physiological indices as an exploratory pathway.</p><p><strong>Methods: </strong>A total of 150 Korean working adults in high-stress occupations completed standardized measures of neuroticism, perceived occupational stress, and burnout. Resting-state frontal electroencephalography (EEG) and photoplethysmography (PPG) signals were collected using the Maumgyeol Basic wearable system to compute EEG indices and heart rate variability (HRV) features. Structural equation modeling, adjusting for age, evaluated parallel mediation via perceived stress and PPG-derived autonomic activity.</p><p><strong>Results: </strong>Neuroticism was associated with greater perceived stress and reduced PPG-based autonomic flexibility. Perceived stress significantly predicted burnout, whereas the PPG-burnout path showed a nonsignificant negative trend. The indirect effect of neuroticism through perceived stress was significant; in contrast, the indirect effect via PPG-derived autonomic activity did not reach statistical significance. Age was inversely associated with burnout.</p><p><strong>Conclusion: </strong>Findings identify perceived stress as the primary mediator linking neuroticism to occupational burnout. Although reduced autonomic flexibility was directionally consistent with burnout risk, the physiological pathway was not statistically supported and remains preliminary. Wearable biosignals may serve as complementary indicators of stress-related vulnerability.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 3","pages":"570-579"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurobehavioral Consequences of Obesity: The Role of Inflammation.","authors":"Gulsen Celebi, Semil Selcen Gocmez, Gozde Tufekci, Selenay Humeyra Furat, Tugce Demirtas, Gulcin Gacar, Furkan Omer Halis, Yusufhan Yazir, Tijen Utkan","doi":"10.9758/cpn.25.1371","DOIUrl":"10.9758/cpn.25.1371","url":null,"abstract":"<p><strong>Objective: </strong>Obesity is a global health concern linked to neuroinflammation, cognitive decline, and depression. Tumor necrosis factor-α (TNF-α) is a key mediator of these effects, and its inhibition may offer therapeutic benefits. This study investigated whether etanercept (ETN), a TNF-α inhibitor, prevents neurobehavioral alterations induced by a cafeteria (CAF) diet in rats.</p><p><strong>Methods: </strong>Male rats were assigned to control, CAF, or CAF + ETN groups for 12 weeks. Cognitive and affective behaviors were assessed by the Morris water maze, passive avoidance, forced swimming, and sucrose preference tests. Hippocampal TNF-α, interleukin-1β, and brain-derived neurotrophic factor (BDNF) levels were measured.</p><p><strong>Results: </strong>CAF-fed rats developed obesity, memory impairment, and depression-like behaviors, accompanied by increased proinflammatory cytokines and reduced BDNF immunoreactivity. ETN attenuated weight gain and improved cognitive and emotional performance with normalized hippocampal proinflammatory cytokines levels. After ETN treatment, BDNF levels significantly increased compared to the CAF group but still remained lower than the controls.</p><p><strong>Conclusion: </strong>The results of the study indicate that TNF-α inhibition alleviates obesity-induced neuroinflammation and rescues cognitive and emotional behavioral impairments, while only partially restoring hippocampal BDNF levels. These results suggest a potential link between TNF-α inhibition and the mitigation of obesity-associated neurobehavioral dysfunction through the suppression of hippocampal neuroinflammation.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 3","pages":"526-536"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroimmune Links to White-matter Microstructure in Medication-naïve Children with Tic Disorder: A Mediation Analysis.","authors":"Dong-Hyun Cha, Su-Hyuk Chi, Woojeong Lee, June Christoph Kang, Jeong-An Gim, Jeong-Kyung Ko, MoonSoo Lee","doi":"10.9758/cpn.25.1376","DOIUrl":"10.9758/cpn.25.1376","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether newly diagnosed pediatric tic disorder is associated with white-matter microstructural alterations on diffusion tensor imaging (DTI) relative to healthy controls, and whether these changes relate to tic severity and circulating pro-inflammatory cytokines.</p><p><strong>Methods: </strong>Twenty-one medication-naïve children with tic disorder and 26 healthy controls underwent 3T DTI and blood sampling. Voxel-wise group differences in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity, and radial diffusivity (RD) were examined using tract-based spatial statistics. In the tic group, correlations between DTI metrics, tic severity (Yale Global Tic Severity Scale scores), and cytokine levels were tested, followed by mediation analysis.</p><p><strong>Results: </strong>Patients showed lower FA and higher MD and RD across multiple tracts, including the corpus callosum, corticospinal tract, inferior longitudinal fasciculus (ILF), and inferior fronto-occipital fasciculus (IFOF). Elevated RD in the left ILF correlated with greater tic severity (ρ = 0.61, <i>p</i> = 0.004). Cytokine-DTI associations were region-specific: higher interleukin-1β was linked to lower FA in the left corticospinal tract and higher MD in the right IFOF, whereas higher tumor necrosis factor-α was associated with lower RD in the right IFOF.</p><p><strong>Conclusion: </strong>Medication-naïve pediatric tic disorder is characterized by widespread white-matter abnormalities that relate to both clinical severity and peripheral inflammation. Integrating DTI and immune measures may facilitate biomarker development and guide neuroinflammation-targeted interventions in pediatric tic disorders.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 3","pages":"558-569"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of Lateral Frontal Delta Asymmetry in Adult Attention-deficit/Hyperactivity Disorder with Comorbid Depression: A Quantitative Electroencephalography Study.","authors":"Suhyung Kim, Young-Chan Kim, Yoo Hyun Um, Tae-Won Kim, Ho-Jun Seo, Seung-Chul Hong, Sung-Hoon Yoon, Jong-Hyun Jeong","doi":"10.9758/cpn.25.1378","DOIUrl":"10.9758/cpn.25.1378","url":null,"abstract":"<p><strong>Objective: </strong>Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood and is frequently comorbid with depression, complicating diagnosis and treatment. Quantitative electroencephalography (qEEG) may aid in distinguishing ADHD alone from ADHD with depression by identifying neurophysiological markers.</p><p><strong>Methods: </strong>This retrospective study included 45 adults with ADHD, 24 with comorbid depression and 21 without. Diagnoses were confirmed through structured Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-based interviews and neuropsychological testing. Resting-state EEGs were recorded with 19 electrodes under eyes-closed conditions. Data underwent artifact rejection and independent component analysis, and spectral power was calculated for delta, theta, alpha, beta, high beta, and gamma bands. Frontal regions and asymmetry indices (Fp2-Fp1, F4-F3, and F8-F7) were analyzed using ranked ANCOVA, adjusting for age, sex, Full-Scale IQ, and current medication status.</p><p><strong>Results: </strong>Demographic factors did not differ between groups. However, the ADHD-only group showed a difference delta asymmetry in the lateral frontal region (F8-F7) compared with the comorbid group (<i>p</i> = 0.024). Additional findings included a tendency toward higher absolute delta power at F8 in the ADHD-only group (<i>p</i> = 0.060), and a pattern of greater left centro-temporal delta power in the comorbid group (<i>p</i> = 0.051).</p><p><strong>Conclusion: </strong>In this pilot study, adults with ADHD with and without comorbid depression showed distinct patterns of frontal delta asymmetry, suggesting that depressive comorbidity may be associated with variability in qEEG features. Further well-powered, longitudinal studies are needed to determine the clinical utility of qEEG as an adjunctive tool in ADHD.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 3","pages":"580-588"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Study Examining Predictors of Treatment Response in Over 1,300 Children and Adolescents with Attention-deficit Hyperactivity Disorder.","authors":"Melike Kevser Gul, Bukrenur Hudayioglu, Esra Demirci, Sevgi Ozmen","doi":"10.9758/cpn.25.1342","DOIUrl":"10.9758/cpn.25.1342","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the predictors of treatment response in children and adolescents with attention-deficit hyperactivity disorder (ADHD).</p><p><strong>Methods: </strong>The study included 1,314 patients with ADHD who came to the child psychiatry department over a 5-year period. The 276 patients whose treatment was changed due to treatment non-response or side effects were included twice for the first and second treatment, so a total of 1,590 patient data were used. Age, sex, initial ADHD severity, ADHD treatment, treatment response, comorbidities, additional treatments, and chronic disease status of the cases were recorded.</p><p><strong>Results: </strong>One thousand twenty-seven (78.16%) of the patients were male and 287 (21.84%) were female. Using the combination therapy of methylphenidate (MPH) and atomoxetine (ATX) as the reference category, ATX monotherapy showed a significantly lower likelihood of responding to treatment. Moderate and marked disorder severity were associated with higher odds compared with severe disorder. Borderline intellectual functioning (BIF), mild intellectual disability, conduct disorder (CD), autism spectrum disorder (ASD), and adjustment disorder (AD) showed significantly lower odds. Older age was significantly associated with response to treatment. In the MPH monotherapy and ATX monotherapy groups, compared to moderate disorder, severe disorder was associated with significantly lower odds. BIF, CD, ASD, enuresis, communication disorders, and AD showed significantly lower odds in MPH group, while only ASD had significantly lower odds in ATX group. Higher ATX dosage was significantly associated with treatment response in this group.</p><p><strong>Conclusion: </strong>Knowing the factors affecting treatment response can be used to predict prognosis.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 3","pages":"490-500"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Corrected QT Interval Changes Following First-dose Long-acting Injectable Antipsychotics: A Retrospective Inpatient Study.","authors":"Hayriye Dilek Hamurcu, Esra Kabadayi Sahin, Ersin Hatice Karslıoğlu, Oğuzhan Uğur, Ali Çayköylü","doi":"10.9758/cpn.25.1374","DOIUrl":"10.9758/cpn.25.1374","url":null,"abstract":"<p><strong>Objective: </strong>Long-acting injectable (LAI) antipsychotics improve adherence and reduce relapse, yet short-term cardiac effects during the initial dosing window remain insufficiently characterized. We examined early corrected QT (QTc) changes within 7-14 days after first LAI dose in psychiatric inpatients and tested whether changes vary by LAI type and common clinical modifiers.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of psychiatric inpatients who received their first LAI antipsychotic during admission. Electrocardiograms (ECG) obtained before LAI initiation and again 7-14 days after injection were analyzed. QTc intervals were calculated using Bazett's formula. The primary outcome was the within-patient QTc change (ΔQTc). Prespecified subgroup analyses examined differences across clinical subgroups.</p><p><strong>Results: </strong>Sixty-three patients had paired ECG recordings. Baseline QTc values were comparable across subgroups. Overall, QTc change after LAI injection was small and not statistically significant (418.7 ± 22.8 ms vs. 421.0 ± 25.0 ms; <i>p</i> = 0.323), and no patient exceeded QTc ≥ 500 ms. Modest QTc increases were observed with second-generation LAIs (<i>p</i> = 0.008), particularly paliperidone palmitate (<i>p</i> = 0.046), as well as with concomitant anticholinergic use (<i>p</i> = 0.024) and medical comorbidity (<i>p</i> = 0.034); however, absolute changes remained < 10 ms. In regression analysis (R² = 0.565), baseline QTc was the only independent predictor of post-injection QTc (β = 0.687, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Early QTc changes after LAI initiation were small and not clinically meaningful. Post-injection QTc was mainly determined by baseline QTc, supporting guideline-concordant ECG monitoring without routine intensified cardiac surveillance in low-risk patients.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 3","pages":"547-557"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}