Journal of Clinical Psychopharmacology最新文献

{"title":"Relapse in Anorexia Nervosa Associated With Tirzepatide: A Case Report.","authors":"Anna I Guerdjikova, Heather Dlugosz, Robert Wolterman, Susan L McElroy","doi":"10.1097/JCP.0000000000001975","DOIUrl":"10.1097/JCP.0000000000001975","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"287-288"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710170","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 Impact of Once Daily Dosing on Protein Binding of Clozapine and Norclozapine.","authors":"Marieke M Beex-Oosterhuis, S F Cedric Lau, Charlotte van Kesteren, Steven Verloop, Koen P Grootens, Gunnar Faber, Arthur R Van Gool, E R Rob Heerdink, Rob J van Marum, Daan J Touw","doi":"10.1097/JCP.0000000000001979","DOIUrl":"10.1097/JCP.0000000000001979","url":null,"abstract":"<p><strong>Purpose/background: </strong>Clozapine and norclozapine are highly protein bound. Currently, clozapine is increasingly prescribed once daily (QD). Higher (once daily) doses may theoretically lead to saturation of protein binding of (nor)clozapine, resulting in increased unbound fractions. This study investigated whether protein binding of clozapine and norclozapine becomes saturated at higher concentrations. Secondly, the correlation between unbound (nor)clozapine fractions and alpha-1 acid glycoprotein (AGP) concentrations was studied.</p><p><strong>Methods/procedures: </strong>From 44 patients taking clozapine QD or twice daily a total of 319 blood samples were collected at different time points within a dose interval. AGP concentrations were measured in samples drawn just before clozapine intake. A validated liquid chromatography-tandem mass spectrometry method was used for quantification of the (nor)clozapine concentrations. Ultrafiltration was used to separate the bound and unbound molecules. The relation between total concentrations and fractions, and between unbound fractions and AGP concentrations were investigated using linear mixed model analysis.</p><p><strong>Findings/results: </strong>There was no significant correlation between total clozapine ( P = 0.270) and norclozapine ( P = 0.678) concentrations and its unbound fractions with total clozapine concentrations up to 1500 μg/L. A statistically significant (negative) correlation between AGP concentrations and clozapine ( P = 0.000) and norclozapine ( P = 0.028) unbound fractions was found.</p><p><strong>Implications/conclusions: </strong>In general, total concentrations remain suitable for therapeutic drug monitoring if clozapine is used once daily. Future research is needed to define if higher total concentrations are warranted in case of lower unbound fractions due to increased AGP concentrations.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"231-235"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597225","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":"Resolution of Catatonia With Cariprazine-A Case Report.","authors":"Alexandra Rockett, Andrew Stoner, Catherine Ironbar, Joseph Chien","doi":"10.1097/JCP.0000000000001993","DOIUrl":"10.1097/JCP.0000000000001993","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"291-293"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700456","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":"Predictors and Correlates of Psychiatric Polypharmacy Among Child and Adolescent Psychiatric Inpatients: A Retrospective Study.","authors":"Sean Lynch, Timothy Becker, Parul Shanker, Dalton Martin, Paige Staudenmaier, Alicia Leong, Timothy Rice","doi":"10.1097/JCP.0000000000001981","DOIUrl":"10.1097/JCP.0000000000001981","url":null,"abstract":"<p><strong>Purpose/background: </strong>Rates of prescriptions of psychotropic medications to youth have increased, a significant proportion of which are recipients of psychiatric polypharmacy. Polypharmacy can increase the risk of multiple negative outcomes. Prior studies attempting to identify predictors/correlates of polypharmacy have been heterogeneous. This study aimed to examine factors associated with polypharmacy among psychiatrically hospitalized youth, and measure changes in polypharmacy over time throughout the COVID-19 pandemic.</p><p><strong>Methods/procedures: </strong>The medical records of 1101 patients were reviewed. Sociodemographic and clinical information was collected and analyzed using SPSS.</p><p><strong>Findings/results: </strong>About one-third of patients received psychotropic polypharmacy; this group contained a higher percentage of males, White patients, and fewer Asian/South Asian patients. They had on average more hospitalizations, a longer hospitalization period, and were more likely to be diagnosed with an impulsive/behavioral disorder, developmental disorder, or bipolar spectrum disorder. They were twice as likely to receive medication for agitation while hospitalized. A regression model identified positive predictors of polypharmacy as having a history of violence and a higher number of psychiatric hospitalizations. Negative predictors included non-White race. The rate of polypharmacy was relatively stable throughout the study time period, and no impact of the COVID-19 pandemic was found.</p><p><strong>Implications/conclusions: </strong>Pediatric psychiatric polypharmacy is relatively common and may be associated with poorer outcomes. Certain sociodemographic and clinical characteristics may aid clinicians in predicting which youth may be at risk for polypharmacy. Longitudinal studies are indicated to examine outcomes of polypharmacy so that providers can effectively implement judicious prescribing practices in the community.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"243-250"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710159","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":"Growing Concerns Over Valproate Teratogenicity Present an Opportunity for Lithium.","authors":"Samuel Dotson, Andrew Nierenberg","doi":"10.1097/JCP.0000000000001948","DOIUrl":"10.1097/JCP.0000000000001948","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"65-66"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921839","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":"Protracted Psychiatric Complications Including Psychosis in a Middle-Aged Man After COVID-19 Vaccination: A Case Report.","authors":"Seshagiri Rao Doddi, Francis Pham, Jennifer Wineke, Christopher Marano, Deborah Brooks","doi":"10.1097/JCP.0000000000001969","DOIUrl":"10.1097/JCP.0000000000001969","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"160-162"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370826","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":"Vasopressor Requirements in Antipsychotic Overdose: A Poison Center Observational Study.","authors":"Natasha Tobarran, Emily K Kershner, Kirk L Cumpston, Andrew Chambers, Avery Michienzi, S Rutherfoord Rose, Nathan Charlton, Brandon K Wills","doi":"10.1097/JCP.0000000000001965","DOIUrl":"10.1097/JCP.0000000000001965","url":null,"abstract":"<p><strong>Purpose/background: </strong>The antipsychotic class of medications has a varying degree of peripheral alpha antagonism resulting vasodilation and potentially hypotension. These hemodynamic changes may require treatment with crystalloids and vasopressors. The primary aim of this study was to evaluate the occurrence of hypotension after antipsychotic overdose and characterize vasopressor use.</p><p><strong>Methods/procedures: </strong>A retrospective cohort study was conducted by chart review of electronic records from 2 regional poison centers from January 1, 2004, to December 31, 2020. Inclusion criteria were single acute antipsychotic exposures evaluated in a health care facility and age >15. Exclusion criteria included missing data, minor or no effect outcomes, and polypharmacy overdose. The primary outcome was hypotension, which was defined as systolic blood pressure <90 mm Hg and/or MAP <65.</p><p><strong>Findings/results: </strong>There were 4488 single acute antipsychotic overdoses that presented to a healthcare facility after the initial search was conducted. After exclusions, there were 2070 cases with moderate or severe outcomes. The mean age was 42 (SD = 16), and 70% were female. There were 169 cases with hypotension. Of the hypotensive cases, 92% involved atypical antipsychotics, with quetiapine being the most common (n = 128, 76%). Vasopressor therapy was administered in 16/169 cases (9.9%). In the cases where vasopressor use was recorded, norepinephrine was used 12 times, dopamine 3 times, and phenylephrine once. No deaths were reported.</p><p><strong>Implications/conclusions: </strong>In antipsychotic overdoses that presented to a healthcare facility, hypotension was present in n = 169 (3.8%).</p><p><strong>Conclusions: </strong>Among patient reports to 2 regional poison centers, we found that hypotension following acute antipsychotic overdose was infrequent and vasopressors are rarely administered.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"92-95"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370827","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":"Second-Generation Antipsychotic-Associated Serious Adverse Events in Women: An Analysis of a National Pharmacoepidemiologic Database.","authors":"Kenneth L McCall, Emily E Leppien, Brian J Piper, Bridgette M Falco, Kara K Fleck, Jacob C Govel, Gianna N Nasta, Steven R Zheng","doi":"10.1097/JCP.0000000000001962","DOIUrl":"10.1097/JCP.0000000000001962","url":null,"abstract":"<p><strong>Purpose: </strong>Women have historically been underrepresented in second-generation antipsychotic (SGA) clinical trials, accounting for less than 35% of participants, which raises concerns about the generalizability of the safety profile for these medications.</p><p><strong>Methods: </strong>The US adverse event reporting system was queried for the dates January 1, 2019, to July 8, 2024, to examine the following 6 SGAs: aripiprazole, clozapine, olanzapine, quetiapine, risperidone, and ziprasidone. Reports were excluded if patients were under 18 years old, contained an unknown age or gender, or were duplicated. Five adverse events were examined: Torsades de pointes (TdP), neuroleptic malignant syndrome (NMS), tardive dyskinesia (TD), agranulocytosis (AG), and cerebrovascular adverse events (CVAE). Counts of these events were noted, and reporting odds ratios (ROR) were calculated.</p><p><strong>Results: </strong>The total study cohort was 87,356 reports, consisting of aripiprazole (n = 10,715, 12.2%), clozapine (n = 25,096, 28.7%), olanzapine (n = 11,587, 13.3%), quetiapine (n = 28,746, 32.9%), risperidone (n = 10,467, 12%), and ziprasidone (n = 745, 0.9%). The cohort's mean age was 48.6 ± 18.5 years and comprised 42,584 females (48.7%). Most cases were reported by healthcare professionals (74,836, 85.7%). A total of 3,754 reports contained at least 1 of the 5 adverse events. The RORs among females compared to males for TdP (5.55, 95% confidence interval [CI] = 3.78-8.47), NMS (0.59, 95% CI = 0.53-0.65), TD (0.88, 95% CI = 0.76-1.02), AG (0.59, 95% CI = 0.51-0.70), and CVAE (1.12, 95% CI = 0.89-1.41) were observed. Females had a significantly higher odds of hospitalization or death with TdP compared to males (ROR = 3.09, 95% CI = 1.36-7.01).</p><p><strong>Conclusions: </strong>Our findings suggest higher odds of TdP and worse TdP-associated outcomes among females exposed to SGAs compared to males. Further studies are needed to confirm these preliminary findings.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":"45 2","pages":"111-115"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523429","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's Altered States Meta-Analysis: The Relationship Between Psychomimetic and Clinical Effects With Focus in Depression.","authors":"Vagner Deuel de O Tavares, Kaike Thiê da Costa Gonçalves, Maria Luiza de Morais Barros, Aldielyson Jorge Cavalcante de Brito, Patrícia Cavalcanti-Ribeiro, Fernanda Palhano-Fontes, Marcelo Falchi-Carvalho, Emerson Arcoverde Nunes, Jerome Sarris, Daniel Perkins, Gisele Fernandes-Osterhold, Draulio Barros de Araujo, Nicole Leite Galvão-Coelho","doi":"10.1097/JCP.0000000000001946","DOIUrl":"10.1097/JCP.0000000000001946","url":null,"abstract":"<p><strong>Background: </strong>In recent years, there has been a significant focus on exploring the potential therapeutic impact of altered states of consciousness on treatment outcomes for mental illness, with the goal of enhancing therapeutic strategies and patient results.</p><p><strong>Methods: </strong>This meta-analysis was designed to investigate the potential link between the psychomimetic effects of ketamine and clinical outcomes in mental health, which adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p><p><strong>Results: </strong>Eleven studies were selected for meta-analysis, and the main result did not find a significant correlation between the psychoactive effects of ketamine and clinical outcomes either in mental illness (n = 11; n's = 27; r = 0.06 [-0.05, 0.17]; P = 0.268) or depression exclusively (n = 10; n's = 25; r = 0.03 [-0.07, 0.13]; P = 0.561). High heterogeneity was found for general analysis ( I2 = 80.78). Egger's regression did not indicate publication bias (intercept = 1.57; SE = 1.49, P = 0.30). No significant Kendall's rank correlation coefficient was observed ( τ = 0.02, P = 0.88) indicating funnel plot symmetry. The sub-analyses, aimed at minimizing study variability by specifically examining factors such as patient disorders (limited to depression), methods of administration (exclusively intravenous), types of assessment instruments, and the timing of evaluations, also yielded no significant findings.</p><p><strong>Conclusion: </strong>This meta-analysis suggests that the altered states of consciousness experienced during ketamine sessions are not directly linked to clinical outcomes. However, it is important to acknowledge that the limited number of studies and their heterogeneity render this conclusion preliminary, warranting further investigation over time.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"127-139"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869389","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 Use in Down Syndrome: A Surprising Paucity of Evidence.","authors":"Mark Ainsley Colijn","doi":"10.1097/JCP.0000000000001953","DOIUrl":"10.1097/JCP.0000000000001953","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"170-171"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978508","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}