Sabrina Wong, Gia Han Le, Angela T H Kwan, Taeho Greg Rhee, Kayla M Teopiz, Roger C Ho, Bing Cao, Joshua D Rosenblat, Rodrigo Mansur, Roger S McIntyre
{"title":"Risk of VMAT2 inhibitors on suicidality and parkinsonism: report utilizing the United States Food and Drug Administration adverse event reporting system.","authors":"Sabrina Wong, Gia Han Le, Angela T H Kwan, Taeho Greg Rhee, Kayla M Teopiz, Roger C Ho, Bing Cao, Joshua D Rosenblat, Rodrigo Mansur, Roger S McIntyre","doi":"10.1097/YIC.0000000000000553","DOIUrl":"10.1097/YIC.0000000000000553","url":null,"abstract":"<p><p>Prescription of vesicular monoamine transporter 2 (VMAT2) inhibitors, valbenazine, deutetrabenazine, and tetrabenazine, is becoming increasingly common in persons treated with antipsychotics. Reported suicidality and parkinsonism are safety concerns with VMAT2 inhibitors. Herein, we aim to evaluate the aforementioned safety outcomes using the FDA Adverse Event Reporting System. Reporting odds ratios (RORs) and lower limits of 95% confidence intervals of information components (IC 025 ) were calculated to quantify VMAT2 inhibitor-associated adverse events. Acetaminophen was the reference agent. Suicidal ideation was significantly associated with VMAT2 inhibitors, with RORs ranging from 2.38 to 10.67 and IC 025 ranging from 0.73 to 2.39. Increased odds of suicidal behavior was observed with tetrabenazine (ROR 3.011, IC 025 0.0087), but not deutetrabenazine or valbenazine. Decreased odds of suicide attempts and completed suicide were observed with VMAT2 inhibitors, with RORs ranging from 0.011 to 0.10 (all IC 025 < 0). Increased odds of parkinsonism were reported for all VMAT2 inhibitors, with RORs and IC 025 ranging from 19.49 to 25.37 and 1.66 to 2.93, respectively. The mixed results with VMAT2 inhibitor-associated suicidality and parkinsonism do not establish causal relationships. The parameters of suicidality may be explained by underlying psychiatric disorders.</p>","PeriodicalId":13698,"journal":{"name":"International Clinical Psychopharmacology","volume":" ","pages":"176-181"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Parasomnia induced by lemborexant: a case report.","authors":"Toshinori Nakamura, Yusuke Arai, Tetsuya Hagiwara, Ryosuke Kitoh, Daimei Sasayama, Shinsuke Washizuka","doi":"10.1097/YIC.0000000000000546","DOIUrl":"10.1097/YIC.0000000000000546","url":null,"abstract":"<p><p>Lemborexant, an orexin receptor antagonist, is effective not only for sleep disorders but also for preventing and treating delirium. To date, no complex sleep-related behaviors due to lemborexant have been reported. Herein, we present the case of a 69-year-old male patient who was hospitalized for oral floor and tongue cancer and developed delirium after surgery; however, upon lemborexant dosage increase, used to treat insomnia, he developed abnormal nocturnal behavior. This symptom rapidly improved when lemborexant was discontinued. Distinguishing parasomnia from delirium is important because the treatment of these two conditions differs. Although rapid eye movement sleep behavior or sleepwalking was the cause of this parasomnia, a definitive diagnosis could not be established. If qualitatively distinct abnormal behavior is observed compared to delirium after increasing lemborexant dosage, the possibility of parasomnia should be considered.</p>","PeriodicalId":13698,"journal":{"name":"International Clinical Psychopharmacology","volume":" ","pages":"182-185"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140093924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nestor Szerman, Pablo Vega, Carlos Roncero, Lola Peris, Lara Grau-López, Ignacio Basurte-Villamor
{"title":"Cariprazine as a maintenance treatment in dual schizophrenia: a 6-month observational study in patients with schizophrenia and cannabis use disorder.","authors":"Nestor Szerman, Pablo Vega, Carlos Roncero, Lola Peris, Lara Grau-López, Ignacio Basurte-Villamor","doi":"10.1097/YIC.0000000000000568","DOIUrl":"10.1097/YIC.0000000000000568","url":null,"abstract":"<p><p>Schizophrenia is often associated with substance use disorders, particularly cannabis use disorder (CUD). However, treatments frequently fail to address both conditions simultaneously. This study aimed to evaluate the antipsychotic effectiveness of cariprazine in patients with both schizophrenia and CUD in a real-world setting. A 6-month observational study was conducted on 58 patients diagnosed with schizophrenia and CUD, treated with cariprazine. Antipsychotic effectiveness was measured using the Positive and Negative Syndrome Scale and the Clinical Global Impression-Schizophrenia Scale, along with the Improvement and Severity scales. Cannabis consumption and addiction severity were assessed using the Cannabis Abuse Screening Test and the Severity of Dependence Scale, while functioning was evaluated with the Sheehan Disability Inventory. Cariprazine treatment resulted in significant improvements in schizophrenia symptoms (Positive and Negative Syndrome Scale change: -47.88 points, P < 0.0001; Clinical Global Impression-Schizophrenia Scale change: -8.26 points, P < 0.0001). Cannabis use and dependence also decreased (Cannabis Abuse Screening Test change: -7.0 points, P < 0.0001; Severity of Dependence Scale change: -7.88 points, P < 0.0001), alongside improvements in functioning (Sheehan Disability Inventory change: -9.48 points, P < 0.0001). These results suggest that cariprazine is effective for both schizophrenia and CUD, though further research is needed to confirm these findings.</p>","PeriodicalId":13698,"journal":{"name":"International Clinical Psychopharmacology","volume":" ","pages":"167-175"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Understanding and treating postpartum depression: a narrative review.","authors":"Vincenzo Cardaci, Matteo Carminati, Mattia Tondello, Basilio Pecorino, Alessandro Serretti, Raffaella Zanardi","doi":"10.1097/YIC.0000000000000560","DOIUrl":"10.1097/YIC.0000000000000560","url":null,"abstract":"<p><p>Postpartum depression (PPD) is an increasingly prevalent but still poorly characterized disorder. Causal and modulating factors include hormones fluctuations, such as estrogen, progesterone, and allopregnolone, pathways imbalances, such as oxytocin and kynurenine, chronobiological factors, and brain imaging alterations. Treatment may differ from the traditional major depression management, while selective serotonin reuptake inhibitors such as sertraline are commonly used and suggested by guidelines, neurosteroids such as brexanolone and the more convenient zuranolone have been recently approved. Newer neurosteroids such as ganaxolone, valaxanolone, and lysaxanolone are currently under development, but also esketamine and psychedelics are promising potential treatments. Other somatic treatments including brain stimulation techniques and light therapy also showed benefit. PPD is therefore increasingly understood as, at least partially, independent from major depressive disorder. Specific and individualized treatments including pharmacological and non-pharmacological therapies are progressively being introduced in the routine clinical practice.</p>","PeriodicalId":13698,"journal":{"name":"International Clinical Psychopharmacology","volume":" ","pages":"127-137"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clotilde Guidetti, Anna Feeney, Rebecca S Hock, Nadia Iovieno, Jesús M Hernández Ortiz, Maurizio Fava, George I Papakostas
{"title":"Antidepressants in the acute treatment of post-traumatic stress disorder in adults: a systematic review and meta-analysis.","authors":"Clotilde Guidetti, Anna Feeney, Rebecca S Hock, Nadia Iovieno, Jesús M Hernández Ortiz, Maurizio Fava, George I Papakostas","doi":"10.1097/YIC.0000000000000554","DOIUrl":"10.1097/YIC.0000000000000554","url":null,"abstract":"<p><p>Currently, there are few pharmacotherapy options for clinicians treating post-traumatic stress disorder (PTSD), and antidepressants are usually the medication of choice. This meta-analysis aimed to review the efficacy of antidepressants in the acute treatment of PTSD in adults while investigating the contribution of study design and placebo response to the findings of these studies. Randomized, double-blind, placebo-controlled clinical trials that compared antidepressants with placebo for acute treatment of PTSD were selected. Standardized mean difference (SMD) in change in Clinician-Administered PTSD Scale scores were pooled after examining for heterogeneity. A random-effects meta-analysis was performed. Twenty-nine antidepressant-placebo comparisons, involving 4575 subjects, were analyzed. The SMD among all studies was 0.25, a small to medium effect size, lower than that in studies of antidepressants in adult major depressive disorder. The SMDs for low and high mean placebo responses, were 0.27 and 0.22, respectively. The overall SMD for paroxetine studies was in the moderate range (0.43) and that for sertraline studies was in the small range (0.12). Our findings suggest that antidepressants have modest efficacy in alleviating PTSD symptoms. Patient-level meta-analyses are required to further explore the potential clinical relevance of sertraline for PTSD.</p>","PeriodicalId":13698,"journal":{"name":"International Clinical Psychopharmacology","volume":" ","pages":"138-147"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy and safety of adjunctive therapy with lumateperone in major depressive disorder: a randomized-, double-blind, placebo-controlled clinical trial.","authors":"Zahra Hosseinnia, Mobina Amanollahi, Bahareh Ahli, Fateme Taghavi Zanjani, Fatemeh Amiri, Melika Jameie, Ahmad Shamabadi, Mohammad-Reza Khodaei Ardakani, Shahin Akhondzadeh","doi":"10.1097/YIC.0000000000000590","DOIUrl":"https://doi.org/10.1097/YIC.0000000000000590","url":null,"abstract":"<p><p>This study aimed to investigate the effects of lumateperone as a combination therapy with sertraline in major depressive disorder (MDD). The 8-week, double-blind, placebo-controlled trial was registered with the Iranian Registry of Clinical Trials (registration date: 2022-03-01, registration number: IRCT20090117001556N141). Patients with MDD were randomized to receive either sertraline (100 mg/day) combined with lumateperone (42 mg/day) or sertraline (100 mg/day) with placebo. The Hamilton Depression Rating Scale (HDRS) was used to assess treatment efficacy. Fifty-eight patients with MDD were analyzed (age: 36.91 ± 9.81 and male: 69.0%). The two groups were comparable across baseline sociodemographic and clinical characteristics except for marital status. There was a significant time × treatment interaction on HDRS (P = 0.027), suggesting greater improvement in depressive symptoms following the lumateperone adjuvant therapy. Compared with the placebo group, a significantly larger proportion of individuals receiving lumateperone experienced an HDRS reduction rate greater than or equal to 50% at weeks 4 (90.0 vs. 60.7%, P = 0.014) and 8 (100 vs. 82.1, P = 0.021). However, the remission rate was not different. No serious adverse events were reported. This study suggests that lumateperone can be considered an effective and safe adjuvant treatment for MDD. Future larger clinical trials with extended follow-up periods are needed to confirm its efficacy for clinical use.</p>","PeriodicalId":13698,"journal":{"name":"International Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luca Pellegrini, Eduardo Cinosi, David Wellsted, Megan Smith, Amanda Busby, Natalie Hall, Umberto Albert, Ibrahim Aslan, Matt Garner, Samuel R Chamberlain, Trevor W Robbins, David S Baldwin, Naomi A Fineberg
{"title":"Effects of transcranial direct current stimulation (tDCS) at different cortical targets on cognition in obsessive-compulsive disorder (OCD): an exploratory analysis.","authors":"Luca Pellegrini, Eduardo Cinosi, David Wellsted, Megan Smith, Amanda Busby, Natalie Hall, Umberto Albert, Ibrahim Aslan, Matt Garner, Samuel R Chamberlain, Trevor W Robbins, David S Baldwin, Naomi A Fineberg","doi":"10.1097/YIC.0000000000000589","DOIUrl":"10.1097/YIC.0000000000000589","url":null,"abstract":"<p><p>Transcranial direct current stimulation (tDCS) holds promise as a treatment for obsessive-compulsive disorder (OCD). Patients with OCD show impairment in specific domains of cognitive flexibility and response inhibition. We previously reported that tDCS produced a positive clinical effect on OCD symptoms. Here, we report a secondary analysis of neurocognitive data. In this randomized, double-blind, sham-controlled, crossover, multicenter feasibility study, adults with a diagnosis of OCD according to the diagnostic and statistical manual of mental disorders, fifth edition (DSM-5) received three courses of clinic-based tDCS, targeting the left orbitofrontal cortex (L-OFC), bilateral supplementary motor area (SMA), and sham, randomly allocated and delivered in counterbalanced order. Cognitive assessments were conducted before and 2-h after the first stimulation in each arm. Nineteen adults were recruited. tDCS of both the L-OFC and SMA significantly improved cognitive inflexibility, while sham treatment did not (paired-sample t test, baseline vs. 2-h after stimulation). No significant effect of tDCS was found for motor impulsivity (stop-signal reaction time) in any of the three arms. In a small sample of patients with OCD, a single administration of tDCS to the L-OFC and SMA produced a rapid improvement in cognitive inflexibility but not in motor impulsivity. A definitive randomized, controlled trial of tDCS targeting both the OFC and SMA, including cognitive markers, is indicated.</p>","PeriodicalId":13698,"journal":{"name":"International Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alberto Raggi, Alessandro Serretti, Raffaele Ferri
{"title":"Treatment options for depression in Parkinson's disease: a mini-review.","authors":"Alberto Raggi, Alessandro Serretti, Raffaele Ferri","doi":"10.1097/YIC.0000000000000588","DOIUrl":"10.1097/YIC.0000000000000588","url":null,"abstract":"<p><p>Depression is a common comorbidity in Parkinson's disease (PD), significantly reducing patients' quality of life. This mini-review examines pharmacological and nonpharmacological therapies for managing depression in PD, analyzing their benefits, and limitations. Pharmacological options include tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), levodopa, dopaminergic agonists, and monoamine oxidase B inhibitors. Nonpharmacological strategies involve brief psychodynamic therapy, cognitive-behavioral therapy (CBT), physical exercise, phytomedicine, massage therapy, music therapy, phototherapy, yoga, repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation, electroconvulsive therapy (ECT), and deep brain stimulation. SSRIs, SNRIs, and some dopamine agonists have shown effectiveness and good tolerability, especially when combined with CBT or rTMS. For severe or refractory cases, ECT remains a viable option. Although many of these therapies show promise, the limited number and scale of studies for each treatment restrict the strength of current evidence. Further large-scale, multicenter randomized-controlled trials are essential to validate these preliminary findings and establish evidence-based guidelines. In addition, the potential benefits of social support and brief psychodynamic therapy in the context of PD-related depression require further exploration to provide holistic care strategies for this population.</p>","PeriodicalId":13698,"journal":{"name":"International Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Enrico Capuzzi, Massimiliano Buoli, Francesco Butturini, Nadia Bolognini, Massimo Clerici
{"title":"Prevalence and correlates of prescription drug abuse and misuse among adult prisoners: a systematic review.","authors":"Enrico Capuzzi, Massimiliano Buoli, Francesco Butturini, Nadia Bolognini, Massimo Clerici","doi":"10.1097/YIC.0000000000000586","DOIUrl":"https://doi.org/10.1097/YIC.0000000000000586","url":null,"abstract":"<p><p>There is a growing concern about the inappropriate use of prescription drugs in correctional facilities because of the impact on mental and physical health, drug interactions, risk of overdoses, and drug-related deaths. This study systematically examines the prevalence of abuse and misuse of prescription medications in correctional facilities and factors associated among adult individuals who are incarcerated. A systematic search was performed including articles in English, up to 31 August 2024. Fourteen relevant studies were included. The most reported prescription drugs in custodial settings were opioid substitution treatments, opioid and non-opioid analgesics, and gabapentinoids. Inappropriate use of benzodiazepines resulted also to be relevant. Inconsistency in the definition of abuse and misuse as well as the important heterogeneity in population characteristics and study designs prevent us to draw definitive conclusions as regards the prevalence of abuse and misuse of prescription treatments in custodial settings. Few and inconsistent correlations emerged from available literature. Monitoring inappropriate use of prescription medicines in correctional facilities is warranted. In particular, institutions, policy-makers, and healthcare professionals should jointly provide appropriate intervention strategies. Future research should be taken into account the important limitations of the existing literature.</p>","PeriodicalId":13698,"journal":{"name":"International Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}