Clinical Neuropharmacology最新文献_第3页

Candesartan for Migraine Prophylaxis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. 坎地沙坦预防偏头痛：随机对照试验的系统回顾和荟萃分析。

IF 1.2 4区医学

Clinical Neuropharmacology Pub Date : 2026-06-17 DOI: 10.1097/WNF.0000000000000694

Mohammed R Abdeldayem, Ahmed Elsherbeeny

{"title":"Candesartan for Migraine Prophylaxis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Mohammed R Abdeldayem, Ahmed Elsherbeeny","doi":"10.1097/WNF.0000000000000694","DOIUrl":"https://doi.org/10.1097/WNF.0000000000000694","url":null,"abstract":"Objectives: This study aimed to synthesize evidence from randomized controlled trials (RCTs) on the efficacy of candesartan for migraine prophylaxis.Background: Migraine is a highly prevalent and disabling neurological disorder for which many patients remain inadequately controlled or intolerant to existing preventive therapies. Although several effective options exist, their use is often limited by adverse effects, contraindications, cost, or restricted access. There is a clear need for effective, safe, affordable, and widely available oral preventive treatments.Methods: We comprehensively searched PubMed, Scopus, Web of Science, and Cochrane Library databases to identify all RCTs assessing candesartan versus placebo for migraine prophylaxis. Eligible RCTs were included, and their data were extracted and analyzed using RevMan Web.Results: Three RCTs comprising 589 participants met the inclusion criteria. Compared with placebo, candesartan significantly reduced monthly migraine days (MMDs) (MD: -1.13; 95% CI: -1.51 to -0.76; P < 0.00001), monthly headache days (MHDs) (MD: -1.25; 95% CI: -1.73 to -0.77; P < 0.00001), and monthly triptan doses (MD: -1.00; 95% CI: -1.36 to -0.65; P < 0.00001). However, the reduction in monthly analgesic doses was not statistically significant (MD: -1.10; 95% CI: -3.13 to 0.94; P = 0.29).Conclusions: Candesartan is effective as a preventive treatment for migraine. However, further studies must be conducted globally in larger, more diverse, and longer-term patient populations.","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918660","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}

引用次数: 0

Mania Following Triple Therapy for Helicobacter pylori: A Probable Case of Metronidazole-induced Antibiomania. 幽门螺杆菌三联治疗后的躁狂症：一例甲硝唑诱发的抗生素狂躁症。

IF 1.2 4区医学

Clinical Neuropharmacology Pub Date : 2026-06-17 DOI: 10.1097/WNF.0000000000000691

Louis Chevalier, Sophie Annette, Coralie Mennessier, Marie-Agnès Lorvellec, Gilles Sipahimalani, Frédérique Gignoux-Froment

{"title":"Mania Following Triple Therapy for Helicobacter pylori: A Probable Case of Metronidazole-induced Antibiomania.","authors":"Louis Chevalier, Sophie Annette, Coralie Mennessier, Marie-Agnès Lorvellec, Gilles Sipahimalani, Frédérique Gignoux-Froment","doi":"10.1097/WNF.0000000000000691","DOIUrl":"https://doi.org/10.1097/WNF.0000000000000691","url":null,"abstract":"Objectives: Antibiotic-induced manic syndromes, or \"antibiomania,\" are rare and not well understood. Clarithromycin and, less commonly, metronidazole have been implicated in such cases. This report aims to present a detailed clinical case and to discuss its relevance in light of current evidence on antibiotic-induced manic reactions.Case: A 54-year-old woman developed acute mania within 24 hours of starting triple therapy for Helicobacter pylori infection (clarithromycin, metronidazole, amoxicillin). All antibiotics were discontinued, and short-term sedation was initiated, resulting in full remission within 48 hours. One month later, she completed a dual regimen excluding metronidazole (clarithromycin and amoxicillin) without psychiatric relapse.Discussion: Using Bégaud's causality algorithm, a \"probable\" link with metronidazole was established based on rapid onset after first exposure, resolution upon withdrawal, and absence of recurrence on re-exposure without metronidazole. Although clarithromycin's risk cannot be ruled out, the clinical course favors metronidazole. Clarithromycin's metabolite may interfere with GABAergic transmission, while metronidazole exhibits documented central neurotoxicity by an unclear mechanism and minor cytochrome P450 inhibition. Pharmacodynamic effects, either from metronidazole alone or synergistically with clarithromycin, are the most plausible cause. The patient had vulnerability factors including a hyperthymic temperament and prior suicidal behavior.Conclusion: This case highlights the importance of monitoring mood symptoms during metronidazole therapy, particularly in patients with affective risk factors, and underscores the need for prompt discontinuation upon psychiatric symptoms.","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263568","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}

引用次数: 0

A Double-blind, Placebo-controlled Study of Lumateperone in the Treatment of Borderline Personality Disorder. Lumateperone治疗边缘型人格障碍的双盲、安慰剂对照研究。

IF 1.2 4区医学

Clinical Neuropharmacology Pub Date : 2026-06-15 DOI: 10.1097/WNF.0000000000000693

Jon E Grant, Sophie Boutouis, Laurie Avila, Megha Neelapu, Dustin Ehsan

{"title":"A Double-blind, Placebo-controlled Study of Lumateperone in the Treatment of Borderline Personality Disorder.","authors":"Jon E Grant, Sophie Boutouis, Laurie Avila, Megha Neelapu, Dustin Ehsan","doi":"10.1097/WNF.0000000000000693","DOIUrl":"10.1097/WNF.0000000000000693","url":null,"abstract":"Objectives: Borderline personality disorder (BPD) is associated with psychosocial dysfunction and has a number of untoward public health associations. There is no established first-line pharmacological treatment for BPD, and available options are not suitable for all individuals. The aim of this study was to evaluate the safety and efficacy of lumateperone in adults with BPD.Methods: Sixty adults with BPD were recruited for a randomized, double-blind, placebo-controlled study. Participants received 8-week treatment with lumateperone (42 mg/day) or identical placebo in a parallel design. The primary efficacy outcome measure was the clinician-rated Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD). Safety data were collected. Effects of active versus placebo treatment were analyzed using a linear mixed-effects regression model that included terms for treatment group, time, and treatment-by-time interaction.Results: There was no significant interaction between treatment and time on the ZAN-BPD scale at week 8. Lumateperone was generally well tolerated. Secondary measures did not result in statistically significant differences from placebo.Conclusions: Lumateperone did not appear to reduce BPD symptoms compared with placebo. These findings also need to be viewed cautiously given the small sample size, large drop-out rate, and robust placebo response.","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359745","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}

引用次数: 0

Linezolid-induced Posterior Reversible Encephalopathy Syndrome: A Case Report and Review of the Literature. 利奈唑胺所致后部可逆性脑病综合征1例报告及文献复习。

IF 1.2 4区医学

Clinical Neuropharmacology Pub Date : 2026-05-01 Epub Date: 2026-02-12 DOI: 10.1097/WNF.0000000000000674

Jamir Pitton Rissardo, Priya Shah, Kaitlyn Piotrowski, Aswathi Sajeendran, Ana Leticia Fornari Caprara, Olga R Thon, Joshua Santucci

{"title":"Linezolid-induced Posterior Reversible Encephalopathy Syndrome: A Case Report and Review of the Literature.","authors":"Jamir Pitton Rissardo, Priya Shah, Kaitlyn Piotrowski, Aswathi Sajeendran, Ana Leticia Fornari Caprara, Olga R Thon, Joshua Santucci","doi":"10.1097/WNF.0000000000000674","DOIUrl":"10.1097/WNF.0000000000000674","url":null,"abstract":"Background/aim: Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic condition characterized by vasogenic edema, altered mental status (AMS), seizures, headaches, and visual disturbances. It is commonly associated with hypertension, cytotoxic drugs, and autoimmune disorders. We report a rare case of PRES likely related to linezolid therapy.Case report: A 77-year-old female with renal cell carcinoma, rheumatoid arthritis, hypertension, and prior thromboembolic events underwent major abdominal surgery complicated by coagulopathy, hemorrhage, and sepsis. Blood cultures grew Enterococcus faecium , and linezolid was initiated. Within 48 hours, she developed AMS and respiratory distress requiring intubation. EEG showed epileptiform discharges, and MRI revealed subarachnoid and intraparenchymal hemorrhage with features of PRES. Linezolid was discontinued, and follow-up MRI demonstrated improvement in bilateral hemispheric edema and hemorrhage. A literature review identified 2 additional cases of linezolid-associated PRES, both with similar neurological symptoms but without hemorrhagic complications. Unlike prior reports, our patient had a prolonged recovery, with only partial improvement at 19 days, likely influenced by comorbidities and associated hemorrhagic lesion.Conclusions: Linezolid-induced PRES is rare but clinically significant. Our case highlights potential hemorrhagic complications and delayed recovery, underscoring the need for early recognition and prompt management.","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"107-113"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389460","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}

引用次数: 0

Opicapone Improves the Pharmacokinetics of Levodopa Administered as Extended-Release Capsules. Opicapone改善左旋多巴缓释胶囊的药代动力学。

IF 1.2 4区医学

Clinical Neuropharmacology Pub Date : 2026-05-01 Epub Date: 2026-04-29 DOI: 10.1097/WNF.0000000000000679

Peter A LeWitt, Olga Klepitskaya, Kurt Olson, Grace Liang, Gordon Loewen

{"title":"Opicapone Improves the Pharmacokinetics of Levodopa Administered as Extended-Release Capsules.","authors":"Peter A LeWitt, Olga Klepitskaya, Kurt Olson, Grace Liang, Gordon Loewen","doi":"10.1097/WNF.0000000000000679","DOIUrl":"10.1097/WNF.0000000000000679","url":null,"abstract":"Objective: Both a catechol-O-methyltransferase inhibitor and extended-release (ER) levodopa formulations may enhance levodopa treatment through a more continuous levodopa delivery to the striatum; the combination of these therapies has not undergone a pharmacokinetic study. We evaluated the effects of once-daily opicapone 50 mg on levodopa plasma pharmacokinetics when added to a carbidopa/levodopa (CD/LD)-ER formulation (RYTARY®).Materials and methods: This was an exploratory, open-label study of levodopa's pharmacokinetics measured over 24 hours in healthy adults. Enrolled individuals received CD/LD-ER three times daily (TID) alone for 3 days, followed by once-daily opicapone for 14 days. On the last 3 days of the opicapone regimen, participants received CD/LD ER TID again. Pharmacokinetic parameters were evaluated after the 3-day exposure to CD/LD-ER alone and with concomitant administration of opicapone.Results: Eighteen healthy adults (9 male, 9 female) entered and completed the study. Levodopa exposure (area under the time-concentration curve) was higher with opicapone than with CD/LD-ER alone across all dosing intervals, including between 21:00 and 07:00 (10801.5 vs. 5153.3 ng/mL·h). Over 24 hours, mean levodopa trough concentration (Ctrough) was higher with opicapone versus CD/LD-ER alone (677.2 vs. 266.8 ng/mL), as was minimum Ctrough (302.9 vs. 41.3 ng/mL). There was a greater increase in Ctrough (208%) than in maximum plasma concentration (75%), decreasing the fluctuation index by 38%.Conclusions: Adding opicapone to CD/LD-ER enhanced levodopa pharmacokinetics in healthy adults, by increasing levodopa trough levels. Notably, opicapone increased overnight and morning levodopa concentrations and decreased daily levodopa concentrations, sub-therapeutic for Parkinson disease patients.","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":"49 3","pages":"136-142"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13166064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147940320","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}

引用次数: 0

Delayed-Onset Cariprazine-Induced Akathisia: A Case Report. 迟发性卡吡嗪致静坐症1例报告。

IF 1.2 4区医学

Clinical Neuropharmacology Pub Date : 2026-05-01 Epub Date: 2026-03-02 DOI: 10.1097/WNF.0000000000000676

Zachary Goodrich, Drew Grehan

{"title":"Delayed-Onset Cariprazine-Induced Akathisia: A Case Report.","authors":"Zachary Goodrich, Drew Grehan","doi":"10.1097/WNF.0000000000000676","DOIUrl":"10.1097/WNF.0000000000000676","url":null,"abstract":"Objective: This case report describes the clinically underrecognized manifestation of delayed-onset akathisia induced by cariprazine occurring 10 weeks after treatment initiation. The secondary objective was to discuss potential pharmacokinetic and pharmacodynamic mechanisms of the drug-induced side effects.Methods: A retrospective review of the patient's medical and psychiatric history was performed in addition to a comprehensive literature review.Results: A 42-year-old female with bipolar disorder and generalized anxiety disorder presented to the emergency department on 3 separate occasions with severe restlessness and insomnia, commonly attributed to her previous history of anxiety. Although initial treatment with lorazepam provided subjective symptom relief, the underlying cause persisted. Psychiatry consultation led to a diagnosis of antipsychotic-induced akathisia and administration of diphenhydramine resulted in rapid improvement. The offending agent, cariprazine, was discontinued, resulting in sustained symptom resolution.Conclusions: This case highlights the challenge of distinguishing akathisia from primary anxiety disorders, in addition to considering this diagnosis beyond the initial treatment period. Akathisia symptoms most commonly present within 4 weeks of initiation or titration of antidopaminergic treatment. However, this timeline may be delayed with cariprazine due to its pharmacokinetic and pharmacodynamic properties.","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"114-118"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389503","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}

引用次数: 0

PCSK9 Inhibitors and Bipolar Disorder: A Drug Target Mendelian Randomization Study. PCSK9抑制剂和双相情感障碍：一项药物靶向孟德尔随机化研究。

IF 1.2 4区医学

Clinical Neuropharmacology Pub Date : 2026-05-01 Epub Date: 2026-03-19 DOI: 10.1097/WNF.0000000000000677

Jin Li, Pei-Sen Yao

{"title":"PCSK9 Inhibitors and Bipolar Disorder: A Drug Target Mendelian Randomization Study.","authors":"Jin Li, Pei-Sen Yao","doi":"10.1097/WNF.0000000000000677","DOIUrl":"10.1097/WNF.0000000000000677","url":null,"abstract":"Objective: Bipolar disorder (BD) patients remain symptomatic. As lipid-lowering drug targets have been linked to BD risk, we used Mendelian randomization (MR) to assess their therapeutic potential.Methods: We conducted MR analyses utilizing genetic variants associated with lipid traits and variants in genes encoding the protein targets of various classes of lipid-lowering drugs. The specific drug classes investigated included 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR), proprotein convertase subtilisin/kexin type 9 (PCSK9), and Niemann-Pick C1-Like 1 (NPC1L1). To determine the effects on BD risk, we meta-analyzed MR estimates for regional variants using data from 2 large sample sets. The genetic variants were weighted based on their associations with low-density LDL-c. For lipid-modifying drug targets that exhibited suggestive significance, we further used eQTL data. In addition, we performed colocalization analysis to assess genetic confounding.Results: Genetically proxied inhibition of PCSK9 was strongly associated with a lower risk of developing BD (IVW MR OR=0.82, 95% CI=0.74-0.91, P =2.12e-04, SD reduction in LDL-c) in PGC data set, and in UK Biobank data set ( P =0.03). Sensitivity analyses yielded no statistically significant evidence of bias arising from pleiotropy or genetic confounding. The posterior probability for a common causal variant between PCSK9 inhibition and BD risk was 80.8%.Conclusions: It was observed that PCSK9 showed significant associations with BD risk. These findings indicate that PCSK9 inhibitors have the potential to serve for the treatment of BD.","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"119-125"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13166066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147484990","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}

引用次数: 0

The Evaluation of Topiramate as a First-Line Medication for Cluster Headache Prophylaxis: A Prospective Observational Cohort Study. 评价托吡酯作为预防丛集性头痛的一线药物：一项前瞻性观察队列研究。

IF 1.2 4区医学

Clinical Neuropharmacology Pub Date : 2026-05-01 Epub Date: 2026-02-23 DOI: 10.1097/WNF.0000000000000678

Javid Shafiyev, Irfan Gahramanov

{"title":"The Evaluation of Topiramate as a First-Line Medication for Cluster Headache Prophylaxis: A Prospective Observational Cohort Study.","authors":"Javid Shafiyev, Irfan Gahramanov","doi":"10.1097/WNF.0000000000000678","DOIUrl":"10.1097/WNF.0000000000000678","url":null,"abstract":"Objective: This study evaluated the effectiveness of topiramate monotherapy in treating episodic and chronic cluster headaches and its impact on headache-related disability and quality-of-life areas not sufficiently addressed in previous literature.Materials and methods: A prospective observational study was conducted between October 2023 and December 2024, including 51 adults diagnosed with cluster headache. Exclusion criteria were other headache types, prior anticonvulsant use, malignancy, pregnancy, or lactation. Patients received topiramate starting at 25 mg/day, titrated weekly up to 100 mg. VAS (0 to 10) and HIT-6 scores were used to assess treatment efficacy and quality of life weekly.Results: The cohort was predominantly male (64.7%) with a mean age of 38.6 years. Significant reductions in both HIT-6 and VAS scores were observed over time in all patients, with similar efficacy between first-line and follow-up users. Chronic patients started with higher HIT-6 scores and showed slower improvement than episodic cases. Somnolence was the most common side effect (19.6%), but no patients discontinued treatment.Conclusion: In this observational cohort, topiramate monotherapy was associated with reductions in pain severity and headache-related disability and was generally well tolerated. These findings suggest that topiramate may be considered as a potential first-line or alternative prophylactic option in selected patients, particularly when treatment choices are limited or polypharmacy is undesirable.","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"126-135"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389523","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}

引用次数: 0

Antisuicidal Effect of Lamotrigine Augmentation in Treatment-Resistant Depression: A Case Report. 增加拉莫三嗪治疗难治性抑郁症的抗自杀效果1例报告。

IF 1.2 4区医学

Clinical Neuropharmacology Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI: 10.1097/WNF.0000000000000668

Kimberly Hsiung, Terako Amison

{"title":"Antisuicidal Effect of Lamotrigine Augmentation in Treatment-Resistant Depression: A Case Report.","authors":"Kimberly Hsiung, Terako Amison","doi":"10.1097/WNF.0000000000000668","DOIUrl":"10.1097/WNF.0000000000000668","url":null,"abstract":"Objectives: Treatment-resistant depression (TRD) is a serious public health burden in the United States and comes with an extremely high suicide risk relative to the general population. Lamotrigine, though approved for use only in bipolar disorder, has been found to augment the effects of an antidepressant in treatment-resistant individuals. However, studies showing an antisuicidal effect of lamotrigine in the TRD population are limited. The objective of this paper is to describe a case of a 58-year-old male with TRD and chronic suicidality who was treated with lamotrigine augmentation of the serotonin-norepinephrine reuptake inhibitor, duloxetine, and experienced a sustained clinical improvement of his suicidality.Methods: Clinical changes in depression and suicidality after initiation of lamotrigine are presented.Results: The patient experienced a brief improvement in depression and sustained improvement in suicidality for 2 years.Conclusions: While there remains insufficient evidence in the literature for a clinical recommendation of the use of lamotrigine for suicidality in the TRD population, our case report introduces the novel possibility of an antisuicidal effect of lamotrigine at the individual level. We suggest clinicians consider its use when other, more robust treatments for suicidality have failed.","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":"49 2","pages":"87-90"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147467215","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}

引用次数: 0

Risk Factors for Symptom Aggravation in Acute Ischemic Stroke Due to Anterior Circulation Large Vessel Occlusion. 前循环大血管闭塞导致急性缺血性卒中症状加重的危险因素。

IF 1.2 4区医学

Clinical Neuropharmacology Pub Date : 2026-03-01 Epub Date: 2026-02-09 DOI: 10.1097/WNF.0000000000000672

Shugai Liu, Tianqiang Pu, Qiang Ran, Lei Tao

{"title":"Risk Factors for Symptom Aggravation in Acute Ischemic Stroke Due to Anterior Circulation Large Vessel Occlusion.","authors":"Shugai Liu, Tianqiang Pu, Qiang Ran, Lei Tao","doi":"10.1097/WNF.0000000000000672","DOIUrl":"10.1097/WNF.0000000000000672","url":null,"abstract":"Objective: This study is designed to expound the risk factors for symptomatic exacerbation of acute ischemic stroke due to anterior circulation large vessel occlusion (AIS-AC-LVO), aiming to inform strategies for preventing disease progression.Methods: Two hundred patients with AIS-AC-LVO were retrospectively analyzed. Baseline data included demographics, vascular risk factors, stroke subtype, admission NIHSS score, core infarct volume, blood pressure, serum lipid profile, homocysteine (Hcy), and neutrophil count. Perioperative variables comprised onset-to-door time (ODT), door-to-procedure time (DPT), intravenous thrombolysis, bridging therapy, occlusion site, anesthesia type, procedure duration, intraoperative rescue interventions, recanalization status, and postoperative sedative use. Patients were classified into exacerbated or nonexacerbated groups according to 7-day neurological outcomes. Univariate analysis, multivariate logistic regression, and receiver operating characteristic (ROC) curve analysis were conducted.Results: Baseline NIHSS score, LDL-C, Hcy, neutrophil count, ODT, procedure duration, core infarct volume, and recanalization rate differed significantly between groups ( P <0.05). Multivariate analysis identified elevated Hcy (OR=2.109, 95% CI: 1.499-2.965), prolonged ODT (OR=1.574, 95% CI: 1.181-2.098), longer procedure duration (OR=1.049, 95% CI: 1.014-1.085), and higher LDL-C (OR=5.398, 95% CI: 1.385-21.036) as independent predictors of symptom worsening. ROC analysis showed strong predictive performance for Hcy (AUC=0.866) and ODT (AUC=0.769) (both P <0.001).Conclusions: Elevated Hcy, elevated LDL-C, and prolonged ODT and procedure duration independently predict short-term neurological deterioration.","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"81-86"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147369343","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}

引用次数: 0