Journal of Clinical Psychopharmacology最新文献

{"title":"Reply to \"Progress on Pharmacogenetic Tests for Antidepressant Drug Selection Requires Properly Designed Studies\".","authors":"Renee E Albers, Alexander Gutin, Boadie W Dunlop","doi":"10.1097/JCP.0000000000002189","DOIUrl":"10.1097/JCP.0000000000002189","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"510-514"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149758","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":"Malignant Catatonia and Neuroleptic Malignant Syndrome Overlap in the Emergency Department: Diagnostic Challenges and Psychopharmacology Considerations.","authors":"Samyukta Girish Menon, Yulia Furlong","doi":"10.1097/JCP.0000000000002172","DOIUrl":"10.1097/JCP.0000000000002172","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"496-498"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499292","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":"The Need to Revise the Paliperidone Palmitate Loading Dose Strategy: Toward Personalized Medicine to Enhance Patient Safety.","authors":"Sheldon H Preskorn, Vy Le","doi":"10.1097/JCP.0000000000002186","DOIUrl":"10.1097/JCP.0000000000002186","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"369-371"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645579","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":"A Pilot, Dose-Finding, Pharmacodynamic and Pharmacokinetic Study of Orally Administered Botanical Kratom.","authors":"Chad J Reissig, Ling Chen, Srikanth C Nallani, E Gregory Hawkins, Steven Galati, Katherine Bonson, Siva Rama Raju Kanumuri, Christopher R McCurdy, Abhisheak Sharma, Beatrice Setnik, Denise Milovan, Debra Kelsh, Dominic Chiapperino","doi":"10.1097/JCP.0000000000002158","DOIUrl":"10.1097/JCP.0000000000002158","url":null,"abstract":"<p><strong>Background: </strong>Kratom ( Mitragyna speciosa ) is a plant indigenous to Southeast Asia. This pilot study evaluated the pharmacodynamic (PD) effects, safety, and pharmacokinetics (PK) of kratom and several of its alkaloids.</p><p><strong>Methods: </strong>Recreational polydrug users (8 participants/cohort; 6 active: 2 placebo, N=40) completed the study. Participants had experience with opioids but were otherwise healthy. This study utilized a double-blind, between-subjects design where participants randomly received a single dose of placebo or kratom. The kratom used in the study had alkaloid levels representative of botanical kratom products (i.e., leaf) previously characterized in the literature and contained trace levels of 7-hydroxymitragynine (7-OH). The starting dose was 1 g and doses of 3, 8, 10, and 12 g were administered after safety reviews after each dose. After dosing, pupillometry and assessments of subjective effects were performed, and blood samples were collected. Safety assessments included adverse events (AE) monitoring, laboratory tests, vital signs, ECG assessments, physical examination findings, and assessment of suicidality.</p><p><strong>Results: </strong>No deaths or serious adverse events (SAEs) occurred. Somnolence, vomiting, and nausea were the most common AEs reported. Kratom alkaloid concentrations showed generally orderly, dose-related effects. At doses ≥3 g, kratom produced pupillary constriction. Few dose-related effects were observed, although the 12 g dose of kratom produced increases on several subjective measures including ratings of \"drug liking.\"</p><p><strong>Conclusions: </strong>This study investigated the safety of single-sourced botanical kratom; the results may not be representative of other kratom-containing products. Kratom produced some opioid-like effects including pupillary constriction, and the 12 g dose produced effects commonly associated with drugs of abuse such as visual analog scale (VAS) ratings of drug liking, good effects, and high.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"386-398"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468144","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":"Pharmacological Treatment and Cognition in Bipolar I Disorder: Evidence From a Prospective Study in India.","authors":"Bhavya Bhavya, Ajay Kumar Shukla, Abhijit Rozatkar, Shubham Atal","doi":"10.1097/JCP.0000000000002162","DOIUrl":"10.1097/JCP.0000000000002162","url":null,"abstract":"<p><strong>Background: </strong>Bipolar I disorder is frequently accompanied by persistent cognitive dysfunction, but the extent to which routine pharmacological treatment influences subjective and objective cognition remains unclear. We sought to examine short-term changes in cognitive functioning among euthymic bipolar I disorder patients receiving routine pharmacotherapy.</p><p><strong>Methods: </strong>In this prospective observational study, adults with bipolar I disorder in euthymia (Young Mania Rating Scale ≤10; Hamilton Depression Rating Scale ≤7) underwent cognitive assessment using the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) and the Montreal Cognitive Assessment (MoCA) at baseline and again after 3 to 4 months. Medication regimens, dose stability, adherence, and clinical variables were recorded. Paired tests evaluated within-subject cognitive change; categorical shifts were examined using the McNemar test. Limitations related to study design were explicitly evaluated.</p><p><strong>Results: </strong>Fifty-one participants were enrolled (median age 39 years), and 50 completed follow-up. COBRA scores improved from 7.48±7.13 to 4.04±5.94 (mean change -3.44; P <0.001), and MoCA scores increased from 23.90±4.89 to 25.84±4.40 (mean change +1.94; P <0.001). The proportion with normal cognition increased from 42% to 78% on MoCA, while COBRA-defined impairment decreased from 20% to 6%. Improvements were observed across medication classes, and no regimen demonstrated consistent superiority.</p><p><strong>Conclusions: </strong>Routine pharmacological treatment was associated with short-term cognitive improvement, but the findings are preliminary and not causal.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"420-426"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147443857","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":"Salute to Our Reviewers.","authors":"","doi":"10.1097/JCP.0000000000002200","DOIUrl":"https://doi.org/10.1097/JCP.0000000000002200","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":"46 4","pages":"518-519"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368564","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":"Salute to Our Reviewers.","authors":"","doi":"10.1097/JCP.0000000000002200","DOIUrl":"https://doi.org/10.1097/JCP.0000000000002200","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":"46 4","pages":"518-519"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308249","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":"Safety of Intravenous Methamphetamine in Patients Taking Mirtazapine: A Two-Site Phase 1b Randomized Controlled Trial.","authors":"Finn Black, Glenn-Milo Santos, Vanessa M McMahan, Annie Fraser, Jesse Clark, Lizette Sturgeon, John Walker, Marta Kochanska, Steve Shoptaw, Phillip O Coffin","doi":"10.1097/JCP.0000000000002148","DOIUrl":"10.1097/JCP.0000000000002148","url":null,"abstract":"<p><strong>Background: </strong>There are no approved medications to treat methamphetamine use disorder. We conducted a phase 1b, inpatient,randomized, double-blind, placebo-controlled, within-subject crossover study to evaluate the safety of mirtazapine, a potential treatment for methamphetamine use disorder with positive phase 2 trial findings, in people receiving intravenous methamphetamine.</p><p><strong>Methods: </strong>Participants received mirtazapine 30 mg or placebo daily for 5 days, underwent an intravenous methamphetamine 30 mg challenge on day 5, followed by 2 days of washout, and then switched to the other study arm and received a second methamphetamine infusion at day 12. We monitored participants for adverse events, cardiovascular effects, and pharmacokinetics.</p><p><strong>Results: </strong>Participants (N = 15; 12 with no opioid use and 3 on methadone maintenance treatment) reached steady state mirtazapine levels before methamphetamine infusions. During the mirtazapine phase, participants reached methamphetamine peak plasma concentration 0.26 hours earlier than the placebo phase ( P = 0.02); no other impacts on methamphetamine pharmacokinetics were observed. Mirtazapine neither attenuated nor enhanced the expected cardiovascular effects of methamphetamine, including in participants receiving methadone maintenance therapy. Adverse events were similar between mirtazapine 30 mg and placebo.</p><p><strong>Conclusions: </strong>Mirtazapine 30 mg was safe and well-tolerated in people receiving a clinically relevant intravenous methamphetamine challenge, supporting further development of this medication for the treatment of methamphetamine use disorder.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"404-411"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13229006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355220","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":"Phase 2 Clinical Trial of MK-1942, a Negative Allosteric Modulator of Metabotropic Glutamate Receptor 2, for Treatment-Resistant Depression.","authors":"Aristide Merola, Yuki Mukai, Tjerk Bueters, Paulette Ceesay, Nicole Dupre, Christine Furtek, Gerard Sanacora, Michael E Thase, Steven D Targum, Sean M Smith, Michael F Egan","doi":"10.1097/JCP.0000000000002171","DOIUrl":"10.1097/JCP.0000000000002171","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate MK-1942, a negative allosteric modulator of mGluR2, for treatment-resistant depression using chronic and intermittent dosing.</p><p><strong>Methods: </strong>Randomized, double-blind, 4-week study of MK-1942 added to stable antidepressant therapy in adults with treatment-resistant depression (NCT04663321). Participants were randomized 2:1:2 to (1) daily MK-1942 titrated from 5 to 20 mg bid, (2) twice-weekly MK-1942 10 mg, or (3) placebo. The endpoints were Montgomery Asberg Depression Rating Scale (MADRS) scores at week 3 (daily MK-1942) and week 1 (twice-weekly MK-1942).</p><p><strong>Results: </strong>The study was terminated following asymptomatic elevations in liver function tests. At termination, ~70% of the planned enrolment was achieved (MK-1942 daily N=40, MK-1942 twice-weekly N=19, placebo N=40). No significant efficacy differences from placebo were seen for either MK-1942 group. The difference in mean change-from-baseline MADRS score for daily MK-1942 vs placebo directionally favored placebo at Week 3 (3.3 [95% CI: -1.4, 8.0]) and all other time points. The difference between twice-weekly MK-1942 and placebo directionally favored placebo at week 1 (1.9 [95% CI: -2.7, 6.4]) but not at later time points (eg, week 4, -1.5 [95% CI: -8.0, 4.9]). Interestingly, at every time point, the difference between twice-weekly and daily MK-1942 directionally favored the twice-weekly group. Discontinuations due to an adverse event were more common with MK-1942 than placebo (daily=10.0%, twice-weekly=15.8%, placebo=2.5%), and dizziness was the most common adverse event (daily=25.0%, twice-weekly=31.6%, placebo=7.5%).</p><p><strong>Conclusions: </strong>Although interpretation of the findings is limited by the early termination of the trial, MK-1942 was not effective in treatment-resistant depression.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"427-432"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147485447","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":"Clozapine for Severe Irritability in Children and Adolescents With Autism Spectrum Disorder: A Retrospective Case Series and Brief Literature Review.","authors":"Ibrahim Sungur, Fevzi Tuna Ocakoğlu, Sezen Kose","doi":"10.1097/JCP.0000000000002181","DOIUrl":"10.1097/JCP.0000000000002181","url":null,"abstract":"<p><strong>Background: </strong>Severe irritability in children and adolescents with autism spectrum disorder (ASD), including aggression toward others, self-injury, and object destruction, is a significant source of distress for individuals and may persist despite behavioral and psychosocial interventions. Although treatment with FDA-approved antipsychotics such as risperidone and aripiprazole is available, clozapine has been considered a potential option for the refractory cases. This study retrospectively examined the clinical response, tolerability, and safety of clozapine in children and adolescents with ASD and severe treatment-resistant irritability.</p><p><strong>Methods: </strong>This retrospective case series included 13 patients under 18 years old with ASD who were treated with clozapine for irritability at a tertiary child and adolescent psychiatry department. Clinical outcomes were assessed using the Clinical Global Impression (CGI) scales, alongside documented emergency visits, hospitalizations, and adverse events.</p><p><strong>Findings: </strong>The mean age at clozapine initiation was 12.6 ± 3.1 years, and 12 patients were male. The most common psychiatric comorbidity in our sample was attention-deficit/hyperactivity disorder (ADHD; n = 6), while 7 patients had comorbid intellectual disability. The mean clozapine dose was 138.4 ± 62.8 mg/d. At the last available follow-up, 8 patients were classified as treatment responders based on CGI-I ratings (CGI-I = 1 or 2), while 5 patients were classified as nonresponders (CGI-I ≥ 3). Sialorrhea, sedation, and increased appetite were the most frequent adverse events; one patient developed transient neutropenia.</p><p><strong>Conclusions: </strong>Clozapine may be an effective and generally well-tolerated option for children and adolescents with ASD and severe treatment-resistant irritability.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"433-439"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592457","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}