International Clinical Psychopharmacology最新文献

{"title":"Acceptability-adjusted speed in psychotic agitation: interpreting pro re nata antipsychotic data in real-world care (commentary on Hatta et al.).","authors":"Vassilis Martiadis","doi":"10.1097/YIC.0000000000000620","DOIUrl":"https://doi.org/10.1097/YIC.0000000000000620","url":null,"abstract":"","PeriodicalId":13698,"journal":{"name":"International Clinical Psychopharmacology","volume":"41 4","pages":"253-255"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054268","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":"Risperidone- and paliperidone-induced hyperprolactinemia in routine clinical practice: demographic and pharmacological determinants from the UAE.","authors":"Dina Aly El-Gabry, Hind Mohd Ahmed, Gabriel Andrade, Marri Subhash Reddy, Karim Abdel Aziz, Amani Alkharoossi, Alyazia Abdulla Alkaabi, Jamila Al Ketbi, Anne Elzein Omara, Mohammed Al Ahbabi, Noura Al Ahbabi, Syed Fahad Javaid, Leena Amiri, Doaa Helmy Barakat, Mouza Al Sabousi, Emmanuel Stip","doi":"10.1097/YIC.0000000000000619","DOIUrl":"10.1097/YIC.0000000000000619","url":null,"abstract":"<p><p>Antipsychotic-induced hyperprolactinemia is a common and clinically relevant adverse effect of dopamine D 2 -blocking agents such as risperidone and paliperidone, yet evidence from Arab populations is scarce. This study explored demographic and pharmacological predictors of hyperprolactinemia in a large UAE cohort. A retrospective cross-sectional study was conducted at the Behavioral Science Institute, Al Ain Hospital, using electronic medical records from 2017 to 2023. Adults (≥18 years) with schizophrenia (Diagnostic and Statistical Manual, fifth edition) treated with risperidone or paliperidone (oral or long-acting injectable) for greater than or equal to 6 weeks before serum prolactin assessment were included. Among 835 patients, the mean age was 40.2 ± 14.0 years; 53.8% were male and 58.4% Emirati. The mean prolactin level was 1126 ± 1334 mIU/l; 61.9% had hyperprolactinemia. The paliperidone-oral group showed the highest mean prolactin (1369 mIU/l; P  = 0.003). Sexual side effects occurred in 9.2%. Predictors included younger age, female gender, non-Emirati nationality, paliperidone use, and aripiprazole cotreatment. Hyperprolactinemia was common, particularly among younger females and patients receiving oral paliperidone, and was accompanied by marked under-recognition of sexual side effects. Our study underscores the need for routine endocrine monitoring, rational prescribing to minimize polypharmacy, and region-specific clinical guidelines in the UAE and Gulf region.</p>","PeriodicalId":13698,"journal":{"name":"International Clinical Psychopharmacology","volume":" ","pages":"232-243"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321485","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":"Long-acting injectable vs. oral antipsychotics during electroconvulsive therapy in psychosis: a retrospective comparative study.","authors":"Hee Won Jeong, Yong Sik Kim, Eui-Joong Kim, Soo-Young Bhang, Jae-Won Choi, Jae Hoon Jeong, Hyoseok Kang, Kyu Young Lee","doi":"10.1097/YIC.0000000000000621","DOIUrl":"10.1097/YIC.0000000000000621","url":null,"abstract":"<p><p>Psychoses are often characterized by relapse and treatment resistance. Patients receiving electroconvulsive therapy (ECT) represent a high-risk subgroup. Although long-acting injectable (LAI) antipsychotics improve adherence compared with oral formulations, studies regarding their effectiveness when combined with ECT remain limited. Our study compared clinical outcomes between LAI and oral antipsychotics administered during ECT to patients with psychosis. We conducted a retrospective chart review of 65 patients, grouped according to antipsychotic formulation. Treatment response was defined by improvement on the Clinical Global Impression-Severity scale. Symptom changes were assessed using the Positive and Negative Syndrome Scale (PANSS). The LAI-ECT group showed a significantly higher response rate compared with the oral-ECT group (72.7 vs. 37.5%, P  = 0.004). In multivariable analyses, LAI use remained significantly associated with treatment response ( P  = 0.007). In the subgroup analysis of 48 patients, the LAI-ECT group exhibited greater reductions in total PANSS scores ( P  = 0.014), which remained significant after adjustment for baseline severity ( P  = 0.034). Greater symptom reductions were observed in the PANSS negative and general psychopathology subscales. These findings suggest an association between concurrent LAI antipsychotic administration during ECT and clinical outcomes, warranting further prospective validation.</p>","PeriodicalId":13698,"journal":{"name":"International Clinical Psychopharmacology","volume":" ","pages":"244-252"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573168","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":"Samidorphan sadness: does the addition of samidorphan to olanzapine have prodepressive effects?","authors":"Jamie A Parkerson, Angelo I Chaia, Sean T Lynch, Ashley N Sterchele","doi":"10.1097/YIC.0000000000000617","DOIUrl":"10.1097/YIC.0000000000000617","url":null,"abstract":"<p><p>Olanzapine-samidorphan (Lybalvi) combines the antipsychotic olanzapine with the opioid receptor modulator samidorphan to mitigate olanzapine-associated weight gain. While clinical trials have supported comparable efficacy and improved metabolic outcomes relative to olanzapine alone, data on mood effects remain limited. We report the case of a 40-year-old man with no prior psychiatric history who was psychiatrically hospitalized, and developed clinically significant dysphoric and depressive symptoms shortly after transitioning from a new prescription of olanzapine monotherapy to olanzapine-samidorphan. His depressive symptoms, including anhedonia, amotivation, and fatigue, resolved rapidly upon resumption of olanzapine alone, with no recurrence over 6 months of follow-up. The temporal association and symptom resolution following discontinuation suggest a possible causal relationship. The pharmacologic profile of samidorphan, as a μ-opioid receptor antagonist and partial κ-agonist, may underlie this effect, as κ-receptor activation has been linked to dysphoria and anhedonia. Although large-scale studies of samidorphan have not demonstrated consistent prodepressive effects, individual susceptibility related to opioid receptor signaling may exist. This case highlights the need for clinical vigilance regarding emergent depressive symptoms in patients prescribed olanzapine-samidorphan, particularly those with prior mood vulnerability. Further investigation is warranted to clarify the neurobiological mechanisms and potential risk factors for mood disturbance associated with samidorphan-containing formulations.</p>","PeriodicalId":13698,"journal":{"name":"International Clinical Psychopharmacology","volume":" ","pages":"258-263"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321480","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":"Antipsychotics in clinical practice: agitation, polypharmacy, and treatment resistance.","authors":"Alessandro Serretti","doi":"10.1097/YIC.0000000000000631","DOIUrl":"https://doi.org/10.1097/YIC.0000000000000631","url":null,"abstract":"","PeriodicalId":13698,"journal":{"name":"International Clinical Psychopharmacology","volume":"41 4","pages":"199-203"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054244","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":"Assessing treatment adherence in psychiatry: a comparison of clinical judgment and therapeutic drug monitoring in acute care.","authors":"Giorgio Pigato, Nicola Meda, Marco Paladin, Tommaso Toffanin, Carlo Artusi, Fabio Sambataro","doi":"10.1097/YIC.0000000000000610","DOIUrl":"10.1097/YIC.0000000000000610","url":null,"abstract":"<p><p>Treatment adherence is the cornerstone of the management of psychiatric disorders in the prevention of acute symptom exacerbation, relapse, and hospitalization. Patients are usually treated with psychotropic polypharmacy, including complex regimens, which may contribute to nonadherence. In this real-world acute setting study, we used direct [therapeutic drug monitoring (TDM)] and indirect (emergency room and acute ward clinical judgments) measures to assess adherence in 145 patients with severe mental illnesses. Logistic regressions were used to predict adherence and agreement between adherence measures. The adherence estimates were predicted by sociodemographic and clinical factors and differed across methods: 24.8% for TDM, 55.9 and 50.4% for emergency room and acute ward clinical judgments, respectively. TDM aligned with clinical judgments in about 50% of cases, whereas the agreement between independent clinical judgments reached 84.9%. The concordance on adherence estimates between methods was influenced by sociodemographics, lifestyle, and clinical factors. Our findings underscore a discrepancy between different methods of adherence estimation. These methods capture distinct aspects of adherence and differ in their applicability and reliability, especially in acute settings. Future studies, integrating direct and indirect adherence estimates, are warranted to improve the accuracy of treatment adherence estimation for decision-making in managing exacerbation of psychiatric disorders.</p>","PeriodicalId":13698,"journal":{"name":"International Clinical Psychopharmacology","volume":" ","pages":"166-175"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13015800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512652","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":"Patient treatment preference as a predictor of clinical outcomes in subjects with treatment-resistant depression: a comparative effectiveness research trial for antidepressant incomplete and nonresponders with treatment-resistant depression (ASCERTAIN-TRD).","authors":"Stefania Chaikali, Clotilde Guidetti, Madhukar H Trivedi, Richard C Shelton, Dan V Iosifescu, Michael E Thase, Manish K Jha, Sanjay J Mathew, Charles DeBattista, Mehmet E Dokucu, Olga Brawman-Mintzer, Glenn W Currier, William Vaughn McCall, Matthew Macaluso, Alexander Bystritsky, Fidel Vila Rodriguez, Erik B Nelson, Albert S Yeung, Leslie C MacGregor, Thomas Carmody, Maurizio Fava, George I Papakostas","doi":"10.1097/YIC.0000000000000608","DOIUrl":"10.1097/YIC.0000000000000608","url":null,"abstract":"<p><p>Major depressive disorder (MDD) is a severe and debilitating illness. Despite the available treatments, clinical outcomes remain suboptimal, and hence, it is crucial to identify predictive factors for response. This is a secondary analysis investigating the relationship between treatment preference and response to treatment in the antidepressant incomplete and non-responders with treatment resistant depression (ASCERTAIN-TRD) trial (NCT02977299) comparing three treatment arms [aripiprazole augmentation, repetitive transcranial magnetic stimulation (rTMS) augmentation, switching to venlafaxine XR or duloxetine] in MDD patients with treatment-resistant depression (TRD) who are currently on ongoing, stable, and adequate antidepressant therapy. Patient treatment preferences were recorded in the study entry. In total, 278 subjects were randomly assigned to one of three treatment groups: aripiprazole ( n  = 92), rTMS ( n  = 70), or venlafaxine/duloxetine ( n  = 98). Of these 278 subjects, 256 (92.1%) had at least one postbaseline Montgomery-Asberg Depression Rating Scale (MADRS) score and a recorded treatment preference and were included in this secondary analysis. In the total population, participants' preferences did not affect their response to treatment, and the change in MADRS score was similar among patients who received their preferred treatment, had no preference, or received treatment against their preference ( P  = 0.49). These results indicate that patient preference is not a significant factor that predisposes to optimal treatment outcomes.</p>","PeriodicalId":13698,"journal":{"name":"International Clinical Psychopharmacology","volume":" ","pages":"184-191"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989086","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":"Unspoken needs: an essential perspective in the treatment of schizophrenia.","authors":"Alessandra Martinelli, Giovanni de Girolamo","doi":"10.1097/YIC.0000000000000612","DOIUrl":"10.1097/YIC.0000000000000612","url":null,"abstract":"<p><p>Despite increasing attention to patient-centered care, the treatment of schizophrenia remains predominantly clinician-driven, with limited integration of patients' subjective needs. This paper critically examines the concept of unmet needs in schizophrenia. While structured tools exist, they are rarely used in routine care, and even less frequently from the patient's perspective. Drawing on international literature and Italian service data, this paper examines the systemic, clinical, and ethical implications of unmet needs, highlighting neglected domains including family support, physical health, and sexual well-being. Comparing mental health systems in Italy, Northern Europe, and the UK reveals systemic differences in the inclusion of patient voice in care planning. Finally, we address the issue of clinician training, proposing a reframing of professional competencies to include active listening, shared decision-making, and coproduction. Integrating patients' voices into need assessment is not optional; it is a prerequisite for meaningful, effective, and equitable care in schizophrenia.</p>","PeriodicalId":13698,"journal":{"name":"International Clinical Psychopharmacology","volume":" ","pages":"192-198"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989098","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":"From cognitive endpoints to clinical reality in schizophrenia: antipsychotic choice, adherence, and functional outcomes.","authors":"Alessandro Serretti","doi":"10.1097/YIC.0000000000000623","DOIUrl":"https://doi.org/10.1097/YIC.0000000000000623","url":null,"abstract":"","PeriodicalId":13698,"journal":{"name":"International Clinical Psychopharmacology","volume":"41 3","pages":"139-143"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528669","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":"Impact of selected second and third generation antipsychotics on cognitive dysfunction in schizophrenia-spectrum disorders. Systematic review and network meta-analysis.","authors":"Paolo Olgiati, Antonino Messina, Vincenzo Oliva, Maria Luca, Antonina Luca, Bernhard T Baune, Raffaele Ferri, Alessandro Serretti","doi":"10.1097/YIC.0000000000000607","DOIUrl":"10.1097/YIC.0000000000000607","url":null,"abstract":"<p><p>Cognitive dysfunction is a core feature of schizophrenia spectrum disorders and a major determinant of functional outcomes. This study aimed to: (a) systematically review randomized controlled trials (RCTs) evaluating the cognitive effects of third-generation antipsychotics (TGAs: brexpiprazole, cariprazine, lumateperone, and lurasidone) and xanomeline-trospium; and (b) perform a network meta-analysis (NMA) including additional second-generation antipsychotics with potential procognitive effects. A systematic literature search identified eligible RCTs, which were combined with trials on aripiprazole, olanzapine, quetiapine, risperidone, and ziprasidone from a previous meta-analysis. A frequentist NMA (random-effects model) was conducted using standardized mean differences (SMDs) in pre-post cognitive scores. Associations between cognitive outcomes, follow-up duration, and SMDs for psychotic symptoms were examined; metaregression controlled for age and psychosis severity. Fourteen RCTs ( n  = 2464) met the inclusion criteria. Lurasidone (Hedges' g  = 0.46) and xanomeline ( g  = 0.30) outperformed placebo in improving global cognitive performance, whereas quetiapine ( g  = 0.64) and cariprazine ( g  = 0.20) had the most favorable impacts on attention. Cognitive SMDs were unrelated to follow-up duration or improvements in psychotic symptoms. Age and baseline psychosis severity did not influence cognitive response. In conclusion, selected second and TGAs, including M1/M4 receptor agonists such as xanomeline, may offer promising treatment options for cognitive dysfunction. Further research should personalize pharmacological strategies based on cognitive profiles.</p>","PeriodicalId":13698,"journal":{"name":"International Clinical Psychopharmacology","volume":" ","pages":"144-165"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13015811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451941","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}