Clinical Neuropharmacology最新文献

{"title":"Clozapine-Memantine Therapy in Catatonia: Clinical Insights From a Case Report and Literature Review.","authors":"Elif Burcu Ersungur Çelik, Cana Aksoy Poyraz, Mehmet Murat Kırpınar, Çağrı Karabacak","doi":"10.1097/WNF.0000000000000696","DOIUrl":"https://doi.org/10.1097/WNF.0000000000000696","url":null,"abstract":"<p><strong>Objectives: </strong>To present a case of catatonia in a patient with schizophrenia successfully managed with clozapine and memantine in the absence of standard treatment options. A focused literature review was also conducted to contextualize the findings within the existing evidence.</p><p><strong>Methods: </strong>A 26-year-old man with schizophrenia presented with classic catatonic symptoms, including mutism, posturing, and negativism. Although a lorazepam challenge confirmed benzodiazepine responsiveness, further use was limited by drug unavailability, and electroconvulsive therapy (ECT) was contraindicated due to a cerebral aneurysm. Clozapine was initiated and titrated to 450 mg/d, followed by adjunctive memantine up to 20 mg/d. Clinical progression was assessed with the Bush-Francis Catatonia Rating Scale (BFCRS).</p><p><strong>Results: </strong>Clozapine treatment led to progressive improvement in motor and verbal functions, followed by accelerated recovery after the addition of memantine. Full remission (BFCRS = 0) was achieved by day 42, with complete functional recovery and sustained stability at the 1-month follow-up. Treatment was well-tolerated without adverse effects. Our focused review of the literature indicated that most reported clozapine-treated catatonia cases involved concomitant benzodiazepines and/or ECT, whereas reports of treatment without these standard interventions were uncommon. Reports describing combined clozapine-memantine treatment were particularly rare.</p><p><strong>Conclusions: </strong>This case demonstrates that clozapine can serve as a viable alternative treatment for catatonia when standard interventions are unavailable or contraindicated. Memantine may offer additional therapeutic benefits; however, further research is required to establish its efficacy. The rarity of similar cases in the literature further highlights the uniqueness of the present clinical scenario.</p>","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Existing Peak-Dose Dyskinesia and Light Body Weight as Predictors of Ropinirole Patch Dose Modification in Parkinson Disease: A Multicenter Retrospective Study.","authors":"Rie Tohge, Satoshi Kaneko, Katsuyasu Kouda, Mitsuaki Oki, Shinya Asayama, Hiroyuki Hatsuta, Reika Wate, Yusuke Yakushiji","doi":"10.1097/WNF.0000000000000686","DOIUrl":"10.1097/WNF.0000000000000686","url":null,"abstract":"<p><strong>Objectives: </strong>A ropinirole patch provides continuous dopaminergic stimulation, permitting its increasing use in clinical practice. Inappropriate dose conversion after switching from other dopamine agonists may cause insufficient efficacy or dose-limiting adverse effects. Moreover, factors influencing dose modification remain unclear. Thus, this study aimed to identify factors associated with the need for dose modification in patients with Parkinson disease who switched from another dopamine agonist to a ropinirole patch.</p><p><strong>Methods: </strong>In this multicenter, retrospective study, dose trajectories over 3 months were categorized as dose reduction, maintenance, or escalation. Clinical characteristics associated with dose changes were assessed using univariate analyses, followed by ordinal logistic regression to identify independent predictors. Correlations among candidate variables were examined for potential dependency.</p><p><strong>Results: </strong>Of the 110 patients screened, 95 were analyzed. Twenty-two patients required dose reduction or discontinuation, primarily because of dyskinesia, hallucinations, or somnolence, whereas 19 required dose escalation because of insufficient efficacy. Univariate analysis identified female sex, lower body weight, and pre-existing peak-dose dyskinesia as significant factors. In multivariate analysis, lower body weight [odds ratio (OR)=1.04; 95% CI=1.00-1.09] and pre-existing peak-dose dyskinesia (OR=0.38; 95% CI=0.15-0.94) independently predicted dose modification. Model comparisons suggested potential dependency between body weight and female sex.</p><p><strong>Conclusions: </strong>Pre-existing peak-dose dyskinesia and lower body weight independently influence the need for ropinirole patch dose modification after switching. Individualized dose titration is recommended, particularly in light-weight patients or those with dyskinesia, and prospective studies are warranted to refine dose conversion strategies.</p>","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"155-160"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Open-Label Study of Single-Dose Psilocybin for Borderline Personality Disorder With Co-Occurring Major Depressive Disorder.","authors":"Jon E Grant, Sophia Boutouis, Margaret O'Brien, Laurie Avila, Megha Neelapu, Dustin Ehsan","doi":"10.1097/WNF.0000000000000683","DOIUrl":"10.1097/WNF.0000000000000683","url":null,"abstract":"<p><strong>Objectives: </strong>Borderline personality disorder (BPD) is often comorbid with major depressive disorder (MDD), and there has been a suggestion in the literature that this comorbidity may interfere with MDD treatment response. Our objective was to conduct a pilot study of psilocybin in adults with BPD and MDD.</p><p><strong>Methods: </strong>Adults aged 18 to 65 years with a DSM-5 diagnosis of MDD and BPD were enrolled in an open-label pilot study of a single dose of psilocybin. Assessments were conducted 1 week before dosing (baseline), on the dosing day (visit 2), and at 1, 2, and 4 weeks postdosing. The co-primary outcome measures were changes in depressive and BPD symptoms from baseline to study endpoint, and we used a paired-samples t test to examine changes in symptoms.</p><p><strong>Results: </strong>Nine participants (4 males; mean age=31.3 y) with MDD and BPD were enrolled. MDD symptoms significantly changed from baseline to visit 5: baseline ( M =28.56, SD=4.53) and final visit ( M =17.22, SD=10.39); t (8)=-4.217, P =0.003; Cohen d =1.41. BPD scores did not significantly change from baseline to study endpoint.</p><p><strong>Conclusions: </strong>This small open-label study resulted in statistically significant improvement in MDD symptoms but not for BPD symptoms. These findings, which await larger clinical trials, suggest that BPD does not appear to interfere with response to depressive symptoms.</p>","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"163-169"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of Propranolol Use and Outcomes in Traumatic Brain Injury at a Level I Trauma Center.","authors":"Aviya Hayon, Stacey L Tannenbaum, Lisaine Lopez-Borges, John Berne, Karen Berger","doi":"10.1097/WNF.0000000000000690","DOIUrl":"10.1097/WNF.0000000000000690","url":null,"abstract":"<p><strong>Objectives: </strong>The Eastern Association for the Surgery of Trauma guidelines conditionally recommend beta blockers for adults with traumatic brain injury (TBI); however, real-world utilization varies widely. This study describes critically ill patients with TBI who received propranolol during their hospitalization.</p><p><strong>Methods: </strong>This was a retrospective study evaluating patients 18 years or older admitted with TBI to the intensive care unit (ICU) at a level 1 trauma center between January 1, 2015, and April 30, 2023. Patients were identified using the institution's trauma registry and propranolol administration records. The primary outcome was to describe propranolol use in patients admitted with TBI. Secondary outcomes included in-hospital mortality, 28-day mortality, ICU and hospital length of stay, and discharge disposition. Safety outcomes included bradycardia, hypotension, or vasopressor use within 12 hours following propranolol administration.</p><p><strong>Results: </strong>A total of 217 patients were included. Most patients (95.9%) sustained blunt TBI, and the most common bleeding site was mixed (39.6%), followed by subdural (20.7%) and subarachnoid (20.7%). Beta blockers were initiated on average by day 8 with a mean duration of 22.9 days. In-hospital mortality was 18.9%, and 27.2% of patients were discharged to home or with home health. Bradycardia was observed in 40.1% of patients and hypotension or vasopressor use in 14.7%.</p><p><strong>Conclusions: </strong>In a predominantly severe TBI patient population, most patients received propranolol after 1 week of admission for an average of 3 weeks. Mortality was close to 20% and approximately a quarter of patients were discharged home on a BB.</p>","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"173-179"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor on Multifocal Myoclonus Associated With Trimethoprim-Sulfamethoxazole: A Case Report.","authors":"Jamir Pitton Rissardo, Ana Leticia Fornari Caprara","doi":"10.1097/WNF.0000000000000688","DOIUrl":"10.1097/WNF.0000000000000688","url":null,"abstract":"","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"170-172"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Low-dose Escitalopram on Cognition and Behavior of Patients With Dementia Without Depression: A Retrospective Study.","authors":"Porimita Chutia, Shailendra Mohan Tripathi, Samiksha Supranjali","doi":"10.1097/WNF.0000000000000675","DOIUrl":"10.1097/WNF.0000000000000675","url":null,"abstract":"<p><strong>Objective: </strong>The role of escitalopram on cognition in patients with dementia is inconclusive. In this study effect of low-dose escitalopram on cognition in subjects with dementia without depression is explored.</p><p><strong>Methods: </strong>This is a retrospective study of subjects aged 60 years or more with a diagnosis of dementia without depression conducted in a tertiary-care hospital in India. Subjects treated with low-dose escitalopram with a follow-up of 12 weeks duration were included. The parameters extracted were sociodemographic characteristics, duration and type of dementia, comorbidities, other psychotropics, and antidementia drugs. The change in Hindi Mental Status Examination score from baseline to fourth, eighth, and 12th weeks is considered the primary outcome measure. In addition, changes in neuropsychiatric symptoms are the secondary outcome measures. Statistical methods include descriptive and comparative analysis, and repeated measures ANOVA was applied to assess change in cognition over time.</p><p><strong>Results: </strong>A total of 44 subjects were included, with a mean age of 73.5 ± 7.42 years and 56.82%. Among the subjects, 79.55% were diagnosed with AD, 11.36% with FTD, and 9.09% with VD, and the average duration of illness was 4.48 ± 2.28 years. Comparison of HMSE score from baseline to fourth, eighth, and 12th week shows a significant difference with P <0.001, with greater improvement in the first 4 weeks. In addition, the NPI and ADL scores showed significant improvement in week-4 with P <0.001.</p><p><strong>Conclusion: </strong>Escitalopram shows a promising effect on cognition, behaviour, and functionality in subjects with dementia in the short term. However, a larger prospective long-term study is needed to validate the study findings.</p>","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"147-151"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venlafaxine Is of Variable Effectiveness in Severe Major Depression, Depending on Patient Treatment Response Expectation.","authors":"Udo Bonnet","doi":"10.1097/WNF.0000000000000681","DOIUrl":"10.1097/WNF.0000000000000681","url":null,"abstract":"<p><strong>Objective: </strong>The importance of contextual factors, such as the patient treatment response expectation for the effectiveness of antidepressants (AD), in the treatment of major depressive disorder (MDD) is still underestimated.</p><p><strong>Methods: </strong>This is a report on the surprising course of treatment of a 47-year-old woman suffering from severe melancholic MDD with pronounced somatic symptoms.</p><p><strong>Results: </strong>The first attempt at treatment with venlafaxine (300 mg/d) failed. During this treatment, the patient was not yet convinced of the effectiveness of an AD for her illness. She did not believe that she had MDD at all. In a second pharmacological treatment period, venlafaxine (150 mg/d) worked excellently. In a special psychoeducative run-up to this second treatment, the patient was able to gain a deeper understanding that she was indeed suffering from MDD. Now she could consider the possibility that AD might be helpful against her severe complaints (\"experienced insight\").</p><p><strong>Conclusion: </strong>The role of treatment response expectation should be given greater consideration in the event of nonresponse to medication.</p>","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"143-146"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-Onset Bipolar Disorder: A Case Report.","authors":"Sonali Shirali, Rose Dever","doi":"10.1097/WNF.0000000000000684","DOIUrl":"10.1097/WNF.0000000000000684","url":null,"abstract":"<p><strong>Objective: </strong>To describe a case of late-onset bipolar affective disorder presenting with acute behavioral disturbance in an individual without prior psychiatric history.</p><p><strong>Methods: </strong>We report the case of a 65-year-old man who presented with bizarre and disruptive behavior in an individual without prior psychiatric history. Clinical evaluation, including a mental status examination, was completed to determine the etiology of his symptoms.</p><p><strong>Results: </strong>The patient was ultimately diagnosed with bipolar affective disorder and was started on the appropriate pharmacological interventions with subsequent improvement.</p><p><strong>Conclusions: </strong>This case exemplifies the growing number of late-onset bipolar presentations in observed clinical settings and underscores the importance of further study on this topic.</p>","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"152-154"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Yesterday Once More: Revisiting Catatonia in an Elderly Stroke Patient.","authors":"Alexandre Yacques, Brendan T Carroll, Tyler Panush, Sophia Ireton","doi":"10.1097/WNF.0000000000000685","DOIUrl":"10.1097/WNF.0000000000000685","url":null,"abstract":"<p><strong>Objectives: </strong>Catatonia in older adults is often under-recognized, particularly when it occurs in the setting of acute medical illness or neurological disease. Benzodiazepines are first-line therapy, yet geriatric prescribing frameworks such as the American Geriatrics Society Beers Criteria discourage benzodiazepine use in older adults, which can contribute to delays in treatment.</p><p><strong>Methods: </strong>We report a 71-year-old woman with prior ischemic stroke and major depressive disorder who presented with failure to thrive, behavioral withdrawal, and motor findings consistent with catatonia. Catatonia severity was assessed with the Bush-Francis Catatonia Rating Scale (BFCRS) and the KANNER scale, and she was treated with lorazepam.</p><p><strong>Results: </strong>BFCRS total score improved from 21 at baseline to 11 following lorazepam titration (0.5 mg three times daily increased to 1 mg three times daily). The KANNER Part II score improved from 18 to 10. Clinically, nursing and therapy documentation noted improved engagement, resumption of oral intake, acceptance of medications and hygiene, and participation in physical therapy. At 1- and 5-month follow-up visits, she had no recurrence of catatonic signs by clinical assessment.</p><p><strong>Conclusions: </strong>This case highlights the need for routine screening for catatonia in medically ill older adults, including those with cerebrovascular disease. When catatonia is present, the risk-benefit balance may favor benzodiazepines despite general geriatric cautions. Explicitly listing catatonia among appropriate indications for benzodiazepines in geriatric prescribing frameworks may reduce treatment delays.</p>","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"161-162"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ketamine for the Treatment of Obsessive-Compulsive Disorder (OCD): A Systematic Review on Efficacy and Tolerability.","authors":"Isabela Heroiu, Gia Han Le, Maria-Christina Sioufi, Christine E Dri, Yang Jing Zheng, Sabrina Wong, Roger S McIntyre","doi":"10.1097/WNF.0000000000000692","DOIUrl":"https://doi.org/10.1097/WNF.0000000000000692","url":null,"abstract":"<p><strong>Objectives: </strong>This systematic review aims to assess the efficacy and tolerability of ketamine in the treatment of obsessive-compulsive disorder.</p><p><strong>Background: </strong>Obsessive-compulsive disorder is a chronic and severe disorder characterized by intrusive thoughts and repetitive behaviours that can cause significant distress. Notwithstanding current treatments and interventions for obsessive-compulsive disorder, some individuals still do not adequately respond to conventional pharmacotherapeutic and/or psychotherapeutic interventions. Emerging evidence indicates that ketamine, an N-methyl-D-aspartate receptor antagonist, could have potential rapid-acting and enduring efficacy in the treatment of obsessive-compulsive disorder.</p><p><strong>Methods: </strong>A systematic search was conducted with OVID, PubMed, and Scopus from database inception to July 2025. Two independent reviewers (I.H. and M.C.S.) screened the studies, assessed methodological quality, and extracted pertinent data. Five studies (3 randomized controlled trials and 2 open-label trials) were deemed eligible for inclusion and included variable routes of administration (intravenous, intramuscular, and oral) and dosing frequencies.</p><p><strong>Results: </strong>Across studies, ketamine consistently and significantly improved overall obsessive-compulsive disorder symptom severity, with reductions up to 50% to 60%; however, the duration of effects varied from a few hours postinfusion to 6 weeks. Overall, ketamine was generally well tolerated.</p><p><strong>Conclusions: </strong>Further research should focus on optimizing ketamine treatment (ie, dosing regimens, routes of administration) for sustained symptom reduction.</p>","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}