Journal of Clinical Psychopharmacology最新文献

{"title":"52-Week Open-Label Safety and Tolerability Study of Centanafadine Sustained Release in Adults With Attention-Deficit/Hyperactivity Disorder.","authors":"Gregory W Mattingly, Osman Turkoglu, Denise Chang, Caroline Ward, Taisa Skubiak, Zhen Zhang, Andrew J Cutler","doi":"10.1097/JCP.0000000000002020","DOIUrl":"10.1097/JCP.0000000000002020","url":null,"abstract":"<p><strong>Background: </strong>Centanafadine (CTN) is a potential first-in-class norepinephrine, dopamine, and serotonin reuptake inhibitor (NDSRI) currently in development for the treatment of attention-deficit/hyperactivity disorder (ADHD) in adults. Safety, tolerability, and exploratory efficacy of CTN sustained release (SR) in adults were assessed over 52 weeks.</p><p><strong>Methods: </strong>Adults were enrolled after completing a phase 3 pivotal trial or de novo. The monitoring schedule employed a screening (up to 28 d for de novo group only), 52-week open-label, and 10-day safety follow-up periods. Participants received CTN SR 400 mg total daily dose, twice daily. Safety assessments included treatment-emergent adverse events (TEAEs), clinical laboratories, vital signs, electrocardiogram measures, the Study Medication Withdrawal Questionnaire, and the Columbia-Suicide Severity Rating Scale. Exploratory efficacy was assessed using the Adult Investigator Symptom Rating Scale (AISRS) and the Clinical Global Impression of Severity (CGI-S). Safety was analyzed with a mixed-effect model; efficacy was reported using summary statistics.</p><p><strong>Results: </strong>Of 662 adults enrolled [mean (SD) age, 36.7 (10.1) y; 51.1% female; 82.9% white], 653 received CTN SR, and 345 completed the trial. Altogether, 61.4% reported ≥1 TEAE, mostly mild or moderate in severity; insomnia (8.0%), nausea (7.7%), diarrhea and headache (7.0% each) were most common. Eighty (12.3%) discontinued because of TEAEs. Serious adverse events occurred in 12 (1.8%) participants; none were CTN SR-related per investigators. AISRS total scores improved up to 57% and CGI-S by 1.5 points from baseline.</p><p><strong>Conclusions: </strong>Results from this trial demonstrate that CTN SR 400 mg is safe and effective for long-term treatment of adults with ADHD.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"454-462"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540405","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":"Mirtazapine for Severe Nausea and Vomiting During Pregnancy: Case Presentations and Recommendations.","authors":"Alicia R Khan, Catherine S Stika, Katherine L Wisner","doi":"10.1097/JCP.0000000000002067","DOIUrl":"https://doi.org/10.1097/JCP.0000000000002067","url":null,"abstract":"<p><strong>Purpose/background: </strong>Severe nausea and vomiting in pregnancy (sNVP) causes numerous detrimental short-term and long-term impacts on the physical and mental health of mothers and newborns, yet treatments are limited. When first-line drugs are ineffective, minimal data on efficacy, safety, and tolerability are available for other agents. Mirtazapine is a compelling potential therapy for sNVP because it is effective in reducing nausea and vomiting in other medically ill populations, and its safety and dosing have been established because it is prescribed to pregnant women for psychiatric disorders.</p><p><strong>Methods/procedures: </strong>We present 2 patients with sNVP. Both had not responded to standard antiemetics recommended by the American College of Obstetricians and Gynecologists (ACOG), including third-line and fourth-line agents. They were admitted to the antepartum unit and treated with mirtazapine 15 mg orally disintegrating tablets in addition to their antiemetic regimen.</p><p><strong>Findings/results: </strong>The symptoms of both patients rapidly improved and were sustained over a 3-week acute treatment phase without requiring dose escalation. They were tapered off other antiemetics with continued symptom control and reported minimal distress from side effects. One patient continued mirtazapine into the maintenance phase and remained symptom-free after taper.</p><p><strong>Implications/conclusions: </strong>The outcomes from 2 carefully evaluated and tracked cases of sNVP requiring hospitalization with successful symptom resolution on mirtazapine are presented. To our knowledge, this series is the first to recommend treatment guidelines for the use of mirtazapine in the obstetric setting. We discuss how to taper and manage side effects as well as considerations for psychiatric referral. Finally, we discuss suggestions for future studies.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955816","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":"Psychiatric and Neurocognitive Adverse Events in Young Users of Nonmedical Nitrous Oxide.","authors":"Margot Lestienne, Alexandra Macgregor, Laurie Surig, Hélène Donnadieu, Etienne Mondesert, Céline Eiden, Hélène Peyrière","doi":"10.1097/JCP.0000000000002070","DOIUrl":"https://doi.org/10.1097/JCP.0000000000002070","url":null,"abstract":"<p><strong>Purpose/background: </strong>For several years, an increase in the nonmedical use of nitrous oxide (N 2 O) has been observed in France, among adolescents and young adults, sometimes associated with severe adverse events.</p><p><strong>Methods/procedures: </strong>Analysis of spontaneous reports (SRs) concerning neuropsychiatric adverse events in N 2 O users, received by the Montpellier addictovigilance centre between 2022 and June 2024, and discussion of the underlying pharmacological mechanisms.</p><p><strong>Findings/results: </strong>Nineteen severe SRs were analysed, mainly in men (73.6%, mean age: 23.1 ± 7.3 y) and concerned psychiatric disorders (n = 11), neurocognitive disorders (n = 2), or both (n = 6). Associated consumptions were mainly cannabis (38.9%). Reported symptoms were psychiatric (mainly behavioural disorders, n = 14; delusion, n = 10), and/or neurocognitive (mainly memory disorders, n = 5; spatiotemporal disorientation, n = 3; cognitive slowing, n = 3).Vitamin B12 dosage was performed in 11 cases (<145 pmol/l: 4 cases, mean: 245.4 ± 118 pmol/l), homocysteine in 10 cases (>15 μmol/l: all cases, mean: 80.3 ± 54 μmol/l), methylmalonic acid in 6 cases (>0.5 μmol/l: 4 cases, mean: 1.2 ± 1.7 μmol/l), and vitamin B9 (<8.83 nmol/l: 2 cases, mean: 16.2 ± 9.7 nmol/l). When performed (n = 8), magnetic resonance imaging revealed white matter abnormalities with punctiform hyperintensities in 6 cases. Twelve have received long-term antipsychotic medication, and 9 vitamin supplementation.N 2 O combines potentially neurotoxic mechanisms: psychoactive (glutamatergic receptor antagonist, opioid/GABAergic effects), biochemical (disruption of vitamin B12 metabolism) and anoxic.</p><p><strong>Implications/conclusions: </strong>These observations highlight the importance and uniqueness of N 2 O-induced neuropsychiatric disorders. N 2 O abuse should be considered in any young patient with psychiatric disorders of unknown origin, particularly when associated with atypical cognitive disorders.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955869","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":"Reversible Valproic Acid-Associated Cerebral Pseudoatrophy in a 53-Year-Old Male With Bipolar I Disorder.","authors":"Yiu-Ching Jennifer Wong, Lingsa Jia","doi":"10.1097/JCP.0000000000002056","DOIUrl":"https://doi.org/10.1097/JCP.0000000000002056","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955818","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 Fatal Case of Recurrent Neuroleptic Malignant Syndrome Without Hyperthermia With the Use of Second-Generation Antipsychotics.","authors":"Jonathan Credo, Jaipreet Singh Virk, Sumra Mubarik, James Alan Bourgeois","doi":"10.1097/JCP.0000000000002072","DOIUrl":"https://doi.org/10.1097/JCP.0000000000002072","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955810","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-Resistant Schizophrenia and Wolff-Parkinson-White Syndrome: A Case Report.","authors":"Ana Carolina Pires, Isabela Faria, Miguel Bajouco, David Mota","doi":"10.1097/JCP.0000000000002055","DOIUrl":"https://doi.org/10.1097/JCP.0000000000002055","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955802","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":"Anticholinergic Equivalence in Psychotropic Medications: A Guide for Psychiatrists.","authors":"Nicolas Badre, Eric Geier","doi":"10.1097/JCP.0000000000002073","DOIUrl":"10.1097/JCP.0000000000002073","url":null,"abstract":"<p><strong>Background: </strong>Anticholinergic side effects from psychotropic medications are common and can lead to significant adverse events, including cognitive impairment and falls, particularly in vulnerable populations like the elderly. The cumulative anticholinergic burden from multiple medications is a critical concern associated with poorer clinical outcomes. Quantifying this burden is essential for safer prescribing.</p><p><strong>Methods: </strong>This article developed an anticholinergic equivalence (AE) table for various psychotropic medications. Diphenhydramine (AE=1) was used as the reference standard. AE values for other drugs were derived from their M1 muscarinic receptor binding affinities (Ki) relative to diphenhydramine. This allows estimation of the diphenhydramine equivalent burden per milligram of a given medication. Antihistaminic properties were also reviewed.</p><p><strong>Results: </strong>An AE table was generated, detailing the anticholinergic potency of numerous psychotropic agents. Values varied significantly, with older tricyclic antidepressants (eg, amitriptyline AE: 8.99) and some antipsychotics (eg, clozapine AE: 6.67, olanzapine AE: 3.08) showing high anticholinergic equivalence. Many sedating medications (eg, quetiapine, mirtazapine) are noted to have potent antihistaminic but low anticholinergic properties, clarifying that sedation is not always due to anticholinergic effects.</p><p><strong>Conclusions: </strong>The anticholinergic equivalence table provides a practical, pharmacologically based tool for psychiatrists to quantify and compare the anticholinergic potential of psychotropic medications. This can aid in minimizing cumulative anticholinergic burden, making more informed prescribing decisions, and ultimately enhancing patient safety and therapeutic outcomes, especially in high-risk groups.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873432","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":"Global Insights Into Antipsychotic Research: Bridging Trends and Gaps in Schizophrenia Care (2000-2024).","authors":"Lina M Gonzalez-Ojeda, Hernando Santamaría-García, Lina M Villegas, Catalina Trujillo-Llano, Juan F Cardona","doi":"10.1097/JCP.0000000000002062","DOIUrl":"https://doi.org/10.1097/JCP.0000000000002062","url":null,"abstract":"<p><strong>Background: </strong>Antipsychotic medications are pivotal in managing schizophrenia (SCZ), offering substantial relief from symptoms. However, their impact on functional outcomes, cognitive performance, social cognition, and quality of life remains a critical area of investigation. This bibliometric analysis examines research trends and insights into the multifaceted effects of antipsychotics on individuals with SCZ over the past 2 decades.</p><p><strong>Methods: </strong>Publications from the Scopus database (2000-2024) were analyzed using VOSviewer (V1.6.18) to conduct keyword co-occurrence, co-authorship, and bibliographic mapping analyses. Key trends and thematic areas were identified through bibliometric metrics.</p><p><strong>Results: </strong>The analysis included 2991 publications, revealing variability in annual publication rates. Schizophrenia Research was the leading journal, while the United States dominated in publication volume, author contributions, and institutional output. Key thematic areas included atypical antipsychotics, cognitive impacts, neurotransmitter mechanisms, treatment modalities, quality of life, cognitive deficits, negative symptoms, and neuroimaging studies. Despite advancements, significant gaps persist in understanding social cognition and the holistic impact of antipsychotics.</p><p><strong>Conclusions: </strong>This bibliometric analysis highlights the complex landscape of antipsychotic research in SCZ, underscoring progress in understanding executive functions, motor side effects, and metabolic impacts. However, the findings reveal a critical need for research into social cognition and culturally diverse populations. Addressing these gaps is essential for developing integrated treatment strategies that combine pharmacological, psychosocial, and family-based interventions. Expanding research to encompass diverse ethnic, cultural, and socioeconomic contexts is imperative for advancing global psychiatric care and ensuring equitable treatment access.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144846661","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":"Weekly Changes in the Clozapine Concentration-to-Dose Ratio During Clozapine Titration in Japanese Patients With Schizophrenia.","authors":"Yuki Kikuchi, Mutsumi Sakata, Kazuro Ikawa, Daisuke Kume, Naoki Horikawa, Hiroshi Komatsu, Hiroaki Tomita","doi":"10.1097/JCP.0000000000002003","DOIUrl":"10.1097/JCP.0000000000002003","url":null,"abstract":"<p><strong>Background: </strong>To prevent inflammatory side effects early in the titration phase of clozapine, international guidelines recommend measuring clozapine blood levels weekly. However, data on such measurements are lacking.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of all patients with schizophrenia who were treated with clozapine for the first time and whose clozapine blood levels were measured for at least 2 consecutive weeks from clozapine initiation at our institution from 2020 to 2024. Patients were divided into 2 groups based on whether they had a fever during the first 6 weeks of clozapine treatment. The clozapine concentration-to-dose (C/D) ratios were compared weekly within 6 weeks after starting clozapine.</p><p><strong>Results: </strong>A total of 28 patients were included in the study, of whom 6 developed a fever and 22 did not. The median C/D ratios in weeks 1 and 2 were significantly higher in patients with a fever than in those without (week 1: 2.12 vs 1.31, P  = 0.0217; week 2: 3.48 vs 1.23, P  = 0.01). There was no significant difference in C/D ratios between the groups from week 3 to week 6. During the first 6 weeks of treatment, C/D ratios increased markedly and showed peaks in patients with fever but remained stable in patients without fever.</p><p><strong>Conclusions: </strong>Measuring clozapine blood levels early in the titration phase helps estimate the metabolic capacity of patients. Furthermore, it is essential to pay attention to inflammation, which may increase clozapine C/D ratios.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"345-348"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788359","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":"Lumateperone for Mixed Features in MDD and Bipolar Depression: Advancing Treatment or Raising New Questions.","authors":"Soumya Surekha, Ashish Kumar Lamiyan, Pankaj Khatri, Amol N Patil","doi":"10.1097/JCP.0000000000002018","DOIUrl":"10.1097/JCP.0000000000002018","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"409"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180570","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}