Journal of Clinical Psychopharmacology最新文献

{"title":"The Association Between Stimulant Medication Use and Mortality.","authors":"John P Morrow, Undina Moreton, Tianchen Xu, Nicholas P Tatonetti, Yuanjia Wang, B Timothy Walsh","doi":"10.1097/JCP.0000000000002066","DOIUrl":"10.1097/JCP.0000000000002066","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the association between prescription stimulant medication use and mortality through an analysis of data in the FDA Adverse Event Reporting System (FAERS) and of electronic health records (EHR) of adult patients at a large metropolitan health care center.</p><p><strong>Methods: </strong>The first analysis estimated the associations between the report of a sudden death event in FAERS with stimulants (methylphenidate, dextroamphetamine, dextroamphetamine-amphetamine, and lisdexamfetamine) and with 30 medications unlikely to be associated with serious adverse cardiovascular events and sudden death (control medications); propensity score matching was used to control for confounding. The second analysis estimated the associations between all-cause mortality with stimulants and with control medications in an self-controlled case series (SCCS) of EHR data; the SCCS method assessed whether, within individuals, there was an association between initiation of stimulant medication and mortality in a subsequent risk period. Data from the FDA Adverse Event Reporting System (FAERS) and from electronic health records (EHR) of adult at a large metropolitan health care center were analyzed.</p><p><strong>Results: </strong>In the FAERS analyses, dextroamphetamine and methylphenidate, as well as the combined stimulant class, were significantly associated with sudden death [dextroamphetamine: RR = 2.24 (95% CI: 1.37-3.65; adjusted P < 0.001); methylphenidate: RR = 2.30 (95% CI: 1.62-3.27; adjusted P < 0.001); stimulant class: RR = 2.02 (95% CI: 1.46-2.79; adjusted P < 0.001)]. In the SCCS analyses, these 2 stimulants as well as the stimulant class were significantly associated with all-cause mortality [dextroamphetamine: RR = 3.96 [95% CI: 2.07-7.56; adjusted P < 0.001); methylphenidate: RR = 4.11 (95% CI: 1.78-9.50; adjusted P < 0.001); stimulant class: RR = 3.53 (95% CI: 1.73-7.20; adjusted P < 0.001)]. In the SCCS analysis, for all stimulants except lisdexamfetamine, the RR increased with the age at first stimulant use.</p><p><strong>Conclusions: </strong>The current results document a significant association between stimulant use and mortality and underscore existing guidance to assess current cardiovascular disease and risk factors when prescribing stimulants, especially for older adults.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137652","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":"Antibiomania: A Systematic Review of Clarithromycin-Associated Manic Episodes.","authors":"Tijana Marković, Ana Todorović, Milica Stojković, Suzana Popović, Dejan Baskić, Sanja Matić","doi":"10.1097/JCP.0000000000002089","DOIUrl":"https://doi.org/10.1097/JCP.0000000000002089","url":null,"abstract":"<p><strong>Purpose: </strong>Antibiomania, a rare adverse reaction, refers to antibiotic-induced mania, with clarithromycin most frequently implicated. Symptoms include mood elevation, hyperactivity, and hallucinations, typically resolving after discontinuation of the drug. This review examines reported cases to better characterize clinical patterns and guide clinical recognition and management.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines and registered with PROSPERO. Literature searches were performed in PubMed/MEDLINE, Web of Science, Scopus, and EMBASE using keywords related to clarithromycin, mania, and psychosis. Studies were included regardless of language or publication date. Data extraction focused on demographic details, clinical presentation, treatment, and causality assessment. The quality of case reports was assessed using standardized criteria. FAERS and EudraVigilance databases were queried to identify spontaneously reported psychiatric adverse events associated with clarithromycin use.</p><p><strong>Results: </strong>A total of 32 studies involving 34 patients were included. Most patients were under 65 years old, with a nearly equal distribution of genders. Manic episodes often included psychotic symptoms and emerged ~4 days after the initiation of clarithromycin, lasting about 3 days. The most common dosage was 500 mg taken twice daily. Rechallenge in 5 cases consistently reproduced the symptoms. Causality assessment using the Naranjo and WHO-UMC score suggested a probable association in most cases. All patients fully recovered after discontinuation.</p><p><strong>Conclusions: </strong>Clarithromycin may trigger secondary mania, emphasizing the need for clinician awareness of this rare psychiatric side effect. Timely recognition and appropriate management can enhance patient outcomes and prevent unnecessary psychiatric interventions.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185716","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":"Fixed-Dose Brexpiprazole and Sertraline Combination Therapy for the Treatment of Posttraumatic Stress Disorder: A Phase 3, Randomized Trial.","authors":"Lori L Davis, Saloni Behl, Daniel Lee, Hui Zeng, Taisa Skubiak, Shelley Weaver, Nanco Hefting, Klaus Groes Larsen, Mary Hobart","doi":"10.1097/JCP.0000000000002076","DOIUrl":"https://doi.org/10.1097/JCP.0000000000002076","url":null,"abstract":"<p><strong>Purpose: </strong>This trial aimed to investigate the efficacy, safety, and tolerability of fixed-dose brexpiprazole in combination with sertraline for posttraumatic stress disorder (PTSD).</p><p><strong>Methods: </strong>This was a phase 3, randomized, parallel-arm trial in adult outpatients with PTSD, across 95 sites in the United States (ClinicalTrials.gov: NCT04174170). After a 1-week placebo run-in, participants entered 11 weeks of randomized (1:1:1) double-blind treatment with brexpiprazole 2 mg/d+sertraline 150 mg/d, brexpiprazole 3 mg/d+sertraline 150 mg/d, or sertraline 150 mg/d+placebo (active control). The primary endpoint was the change in Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) total score from randomization (week 1) to week 10. Safety was also assessed.</p><p><strong>Findings: </strong>The trial (October 2019 to August 2023) screened 1821 participants, and randomized 553 (brexpiprazole 2 mg+sertraline, n=191; brexpiprazole 3 mg+sertraline, n=185; and sertraline+placebo, n=177). All groups showed CAPS-5 total score reductions [LS mean (SE) change at week 10: brexpiprazole 2 mg+sertraline, -16.5 (1.2), n=132; brexpiprazole 3 mg+sertraline, -18.3 (1.2), n=124; and sertraline+placebo, -17.6 (1.2), n=130]. LS mean differences (95% CI) versus sertraline+placebo at week 10: brexpiprazole 2 mg+sertraline, 1.03 (-2.09 to 4.16), P=0.52; brexpiprazole 3 mg+sertraline, -0.71 (-3.88 to 2.46), P=0.66. Treatment-emergent adverse events with incidence ≥5% for either brexpiprazole+sertraline group were headache (brexpiprazole 2 mg+sertraline, 7.0%; brexpiprazole 3 mg+sertraline, 5.6%; and sertraline+placebo, 7.6%), nausea (4.9%; 8.3%; 8.7%), and diarrhea (3.8%; 6.1%; 6.4%).</p><p><strong>Conclusions: </strong>PTSD symptom improvement was similar with fixed-dose brexpiprazole+sertraline and sertraline+placebo; the primary endpoint was not met. This differs from 2 prior trials that showed greater efficacy for brexpiprazole+sertraline versus sertraline+placebo. No new safety signals were observed.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124828","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":"Escitalopram-Associated Drug Rash: A Case Report.","authors":"Elliott S Brown, Fabiano G Nery, Kelly Haller, Spencer M Gardner","doi":"10.1097/JCP.0000000000002068","DOIUrl":"https://doi.org/10.1097/JCP.0000000000002068","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113399","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-Related Appendicitis: UK Pharmacovigilance Data, 1992-2022.","authors":"Robert James Flanagan, Simon Alfred Handley, Charlotte James, Lilly Wells, Susanna Every-Palmer","doi":"10.1097/JCP.0000000000002064","DOIUrl":"https://doi.org/10.1097/JCP.0000000000002064","url":null,"abstract":"<p><strong>Purpose/background: </strong>An association between appendicitis and clozapine has been reported, but not studied systematically.</p><p><strong>Methods/procedures: </strong>To document records of clozapine-associated appendicitis/appendectomy, we audited UK MHRA Yellow Card reports classified as clozapine-related gastrointestinal disorders, from 1992 to the end of 2022.</p><p><strong>Findings/results: </strong>There were 65 unique reports (48 males) where appendicitis/appendectomy were documented and confirmed as occurring while the patient was taking clozapine. There were no significant differences in median age (40/45 y), clozapine dose (362.5/325mg d-1), and in the duration of clozapine treatment before the index event (1296/780 d) between men/women, respectively. The reports were coded under 29 different adverse drug reaction terms, most commonly those mentioning abdominal pain (16), constipation (17), ileus paralytic (15), intestinal obstruction (11), and vomiting (13). \"Appendix disorder\" was only mentioned 4 times. Overall, the coded terms reflected those associated with harmful clozapine-induced gastrointestinal hypomotility (CIGH). The annual number of reports reached 10 in 2011, but have since fallen (no reports: 2022). Appendectomy was recorded 59 times. Peritonitis was mentioned in 10 reports (all 3 deaths), but may have featured in other cases. According to the data, clozapine was continued postoperatively in 27 instances, but stopped in 16.</p><p><strong>Implications/conclusions: </strong>The data suggest that appendicitis while taking clozapine is often a manifestation of harmful CIGH and can occur at any stage once treatment is established. Every effort must be made to monitor bowel function and ensure that laxative treatment is adhered to when prescribing clozapine.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075406","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":"Ketamine as a Potential Neuromodulatory Treatment for Long COVID Neuropsychiatric and Neuropathic Symptoms: A Case Report.","authors":"W Michael Brode, Jacqueline Posada, Divya Nagireddy","doi":"10.1097/JCP.0000000000002087","DOIUrl":"https://doi.org/10.1097/JCP.0000000000002087","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064346","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 Olanzapine in a General Hospital Population.","authors":"Joseph D Dragonetti, Jacqueline G Posada, Gregory J Ziomek, Sussann G Kotara, Blair E Walker, Richard Garrett Key","doi":"10.1097/JCP.0000000000002065","DOIUrl":"https://doi.org/10.1097/JCP.0000000000002065","url":null,"abstract":"<p><strong>Background: </strong>This study's goal was to assess the safety of intravenous (IV) olanzapine for general hospital inpatients.</p><p><strong>Methods: </strong>Data were collected through retrospective chart review for any patient who received at least one dose of intravenous olanzapine between January 2013 and December 2022. Primary outcomes were vital sign abnormalities (blood pressure, heart rate, respiratory rate, and oxygen saturation) in the 4 hours following each administration of IV olanzapine. Secondary outcomes were intubation or death following a dose of IV olanzapine. This study was approved by the Institutional Review Board.</p><p><strong>Results: </strong>Three hundred four unique inpatients were found who had received at least one dose of IV olanzapine, and a total of 1214 administrations of IV olanzapine were identified. Doses ranged from 1 to 20 mg, with 5 mg being the most common. Agitation was the most common indication when one was provided (66% of doses). Of doses, 95% were associated with a simultaneous order for at least one class of potentially confounding medications (antihypertensives, other antipsychotics, opioids, or benzodiazepines). Of IV olanzapine doses, 7.41% were associated with at least one vital sign-related adverse drug effect (ADE) and 15.23% of doses above 5 mg were associated with an ADE.</p><p><strong>Conclusions: </strong>IV olanzapine appears reasonably safe in single or repeated doses for patients hospitalized in the general hospital. Doses above 5 mg appear to have a significantly higher risk of ADEs. Future trials will be important to better clarify the safety and effectiveness of IV olanzapine.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040274","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":"Delirium and Catatonia: Emerging Evidence for a Distinct Clinical Syndrome?","authors":"Francisco José Appiani","doi":"10.1097/JCP.0000000000002086","DOIUrl":"https://doi.org/10.1097/JCP.0000000000002086","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023466","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":"Levodopa Augmentation of Antipsychotics for Persistent Negative Symptoms in Schizophrenia: An Open-Label Study.","authors":"Vijay Kumar, Veena Ramesh, Shayanth Manchegowda, M Krishna Prasad, Naren Rao","doi":"10.1097/JCP.0000000000002084","DOIUrl":"https://doi.org/10.1097/JCP.0000000000002084","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023427","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":"Restless Legs Syndrome Associated With Brexpiprazole: A Case Report.","authors":"Ryu Nakarai, Hiroo Mukai, Yuuki Souma, Hiroyoshi Takeuchi","doi":"10.1097/JCP.0000000000002080","DOIUrl":"https://doi.org/10.1097/JCP.0000000000002080","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023481","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}