Journal of Clinical Psychopharmacology最新文献

{"title":"Antidepressant Non-refill as a Proxy Measure for Medication Acceptability in Electronic Health Records.","authors":"Jorge A Sanchez-Ruiz, Melissa Solares-Bravo, Gregory D Jenkins, Nicolas A Nuñez, Nicole I Leibman, Ahmed T Ahmed, Suzette J Bielinski, Richard M Weinshilboum, Liewei Wang, Mark A Frye, Joanna M Biernacka, Aysegul Ozerdem","doi":"10.1097/JCP.0000000000002001","DOIUrl":"10.1097/JCP.0000000000002001","url":null,"abstract":"<p><strong>Background: </strong>Pharmacogenomic studies on antidepressant treatment outcomes could be conducted using previously collected data from electronic health record (EHR)-linked biobanks. However, absence of EHR based outcome measures is an unmet need in designing such studies We aimed to define EHR-derived antidepressant outcome measures and explore their utility in showing associations between treatment outcomes and Cytochrome P450 (CYP) metabolizer phenotypes in a proof-of-concept study.</p><p><strong>Methods: </strong>Using data from the EHR-linked cohort, Right Drug, Right Dose, Right Time: Using Genomic Data to Individualize Treatment (RIGHT 10K) Study, we collected prescription data and patient health questionnaire 9 (PHQ-9) scores to compute 3 proxy measures for antidepressant response, efficacy, and acceptability: change in PHQ-9 scores, longest treatment interval with a single antidepressant, and antidepressant non-refill. Subsequently, we tested the association of both prescription-based outcomes with DNA-predicted CYP metabolizer phenotypes in European-ancestry participants.</p><p><strong>Results: </strong>We identified 3920 RIGHT 10K participants with at least 1 antidepressant prescription and European-ancestry. Participants had a mean age of 61 years and 72% were women. Implementation of the PHQ-9 outcome was not feasible because of missingness. Of both prescription-based outcomes, antidepressant non-refill reproduced several known antidepressant-CYP interactions. However, the pilot was limited by small subgroups of participants with non-normal metabolizer phenotypes.</p><p><strong>Conclusions: </strong>Derived from structured data, antidepressant non-refill is a promising outcome measure for EHR-linked biobanks that partially reproduced antidepressant-CYP interactions. However, testing on larger datasets is necessary to understand whether it would be a useful for pharmacogenomic research.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"310-319"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803437","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":"The Role of Glucagon-Like Peptide-1 Receptor Agonists in the Treatment of Alcohol Use Disorder: Current Evidence and Future Directions.","authors":"Sree Sudha Tanguturi Yella, Krishna Sasanka Kota Sesha Brahma Sree, Sumit Kumar Mahato","doi":"10.1097/JCP.0000000000002010","DOIUrl":"10.1097/JCP.0000000000002010","url":null,"abstract":"<p><strong>Abstract: </strong>Alcohol use disorder (AUD) poses a substantial challenge to public health, marked by persistent alcohol consumption patterns that result in significant morbidity and mortality. The limited efficacy of current pharmacological treatments for AUD underscores the necessity for novel therapeutic approaches. Glucagon-like peptide-1 (GLP-1) receptor agonists, originally developed to treat type 2 diabetes and obesity, have shown promise as potential AUD treatments due to their influence on brain reward pathways. This narrative review synthesizes existing preclinical and clinical evidence on the effects of GLP-1 receptor agonists on alcohol-related behaviors and consumption. Animal studies demonstrate that activating GLP-1 receptors can substantially reduce alcohol intake and inhibit relapse. Initial clinical trials indicate that these agents may decrease heavy drinking days in certain groups, particularly those with concurrent obesity. However, significant gaps remain in the research, including the need for extended studies, more diverse human trials, and investigations into genetic influences on treatment outcomes. This review emphasizes the potential of GLP-1 receptor agonists in AUD treatment and advocates for additional research to confirm their effectiveness and safety in clinical contexts, potentially leading to innovative strategies for managing AUD.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"372-375"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784384","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":"Real-World Impact of Pharmacogenomic Testing on Medication Use and Healthcare Resource Utilization in Patients With Major Depressive Disorder.","authors":"Andria L Del Tredici, Holly L Johnson, Brady DeHart, Alexander Gutin, Pamela Morin, Chelsea R Kasten, Laura Becker, Katherine Johansen Taber, Devika Chawla, Andrew A Nierenberg","doi":"10.1097/JCP.0000000000001999","DOIUrl":"10.1097/JCP.0000000000001999","url":null,"abstract":"<p><strong>Background: </strong>Pharmacogenomic (PGx) testing can help improve response and remission rates for patients with major depressive disorder (MDD) and at least one treatment failure. To investigate real-world outcomes, we examined 1) significant gene-drug interactions (GDIs) and 2) healthcare resource utilization (HRU) in a large US insurance claims dataset.</p><p><strong>Methods: </strong>Weighted multigene PGx testing results in adult patients with MDD were linked with deidentified US claims data. The PGx test report organized medications as congruent (no known or moderate GDI) or incongruent (significant GDI). Medication claims data before and after PGx testing was used to categorize patients as no change in congruency, incongruent-to-congruent, or congruent-to-incongruent. HRU (hospitalizations and emergency department visits) was compared in the 180 days before and after PGx testing.</p><p><strong>Results: </strong>A total of 20,933 patients met inclusion criteria; 16,965 of whom filled medication prescriptions before and after PGx testing. After PGx testing, the proportion of patients filling prescriptions with significant GDIs was reduced (26.1% pretesting vs 15.9% posttesting). All HRU was significantly reduced ( P  < 0.001) after PGx testing except for nonpsychiatric hospitalizations ( P  > 0.05). Psychiatric hospitalizations were significantly reduced after PGx testing in the incongruent-to-congruent and no change in congruency categories ( P  < 0.001), but not in the congruent-to-incongruent category. Conversely, emergency department visits were significantly reduced after PGx testing in all congruency categories ( P  < 0.005) and did not differ when compared across congruency categories.</p><p><strong>Conclusions: </strong>After PGx testing, patients with MDD had decreased prescribing of medications with significant GDI and reduced HRU. PGx testing may have influenced these outcomes, but the retrospective study design limits clarity on its impact.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"320-328"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998002","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":"Use of Clozapine in Pregnancy: A Retrospective Study From North India.","authors":"Sandeep Grover, Surabhi Gupta","doi":"10.1097/JCP.0000000000002013","DOIUrl":"10.1097/JCP.0000000000002013","url":null,"abstract":"<p><strong>Background: </strong>There is limited information on the use of clozapine during pregnancy. This retrospective study aimed to assess pregnancy-related outcomes in women exposed to clozapine. The additional aim was to assess the outcome of the infants at the last follow-up.</p><p><strong>Methods: </strong>Treatment records of all the female patients in the database were evaluated for conception, pregnancy, lactation-related information, and the long-term outcome of the infants.</p><p><strong>Results: </strong>We analyzed 14 pregnancies in 12 women. Most pregnancies (71.4%) were unplanned. A small number of mothers experienced hypertension (14.3%) and gestational diabetes mellitus (7.1%) during the pregnancy. Of 14 pregnancies, 5 (35.7%) ended in miscarriage, while 9 resulted in live births, including 6 normal vaginal deliveries and 3 cesarean sections. No congenital malformations were noted. Neonatal outcomes included 1 case of fetal macrosomia and another with meconium aspiration. Breastfeeding was done in 3 out of 9 infants with no hematological or other adverse outcomes for the infants. In terms of the long-term outcome of neonates, at the mean follow-up period of 8.88 (SD: 6.33; range: 1-18) months, the growth was normal for 8 infants. Information for one infant was not available.</p><p><strong>Conclusions: </strong>The use of clozapine in pregnancy is not associated with congenital malformations but was found to be associated with miscarriage in one-third of pregnancies. There is a need for long-term prospective studies to evaluate the impact of clozapine on pregnancy and neonatal outcomes.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"353-355"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009471","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":"Does Aripiprazole Increase Compulsive Urges to Use Substances? Case Reports and Literature Review.","authors":"Kamini Vasudev, Megha Kodancha","doi":"10.1097/JCP.0000000000002005","DOIUrl":"10.1097/JCP.0000000000002005","url":null,"abstract":"<p><strong>Purpose/background: </strong>Aripiprazole is commonly used to treat schizophrenia, bipolar disorder, and major depressive disorder and is preferred because of its relatively favorable side-effect profile. In 2016, the Food and Drug Administration released a warning regarding the risk of new impulse control problems with aripiprazole, including urges to gamble, binge eat, shop, and engage in sexual intercourse. These problems are rare but may cause significant harm if not recognized in time.</p><p><strong>Methods: </strong>This report presents 2 clinical cases to hypothesize that aripiprazole may increase urges and compulsive use of substances in some patients with a history of substance use disorders.</p><p><strong>Results: </strong>Both individuals had a previous history of substance use disorder before starting aripiprazole; they felt unable to stop using, as if compelled to use the substances while on aripiprazole, despite having good motivation to change. They reported a decreased urge to use substances after discontinuation of aripiprazole and were able to abstain from substances for sustained periods.</p><p><strong>Implications/conclusions: </strong>These case reports suggest that aripiprazole may increase urges and compulsive substance use in patients with a history of substance use disorders. The findings emphasize the importance of a thorough preprescription assessment, education, informed consent, and regular monitoring of patients prescribed aripiprazole for increased urges or compulsions to use substances, in addition to other impulsive-compulsive behaviors. Further research is needed to confirm the association.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"349-352"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779996","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":"Awake Bruxism Onset and Exacerbation Associated With Lisdexamfetamine Dimesylate Intake: Insights from 2 Case Reports.","authors":"Matheus Herreira-Ferreira, Tatiana Prosini da Fonte, Carolina Ortigosa Cunha, Leonardo Rigoldi Bonjardim, Paulo César Rodrigues Conti, Juliana Stuginski-Barbosa","doi":"10.1097/JCP.0000000000002012","DOIUrl":"10.1097/JCP.0000000000002012","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"401-404"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020612","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":"Manic Switch Associated With Primidone in a Patient Treated for Essential Tremor.","authors":"Francisca Braga, Raquel Luís Medinas, Bruna Meira, Gonçalo Cotovio, Ricardo Caetano Silva","doi":"10.1097/JCP.0000000000002008","DOIUrl":"10.1097/JCP.0000000000002008","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"391-393"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779924","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":"Plasma Clozapine in Treatment Refractory Schizophrenia: What Is the Target Range?","authors":"Robert James Flanagan, Stephen John Obee, Alice Hyun Min Kim, Susanna Every-Palmer, Paula Liren Valbuena Sanchez, Lauren Evans, Jonathan Rogers, Suzanne Reeves","doi":"10.1097/JCP.0000000000002007","DOIUrl":"10.1097/JCP.0000000000002007","url":null,"abstract":"<p><strong>Background: </strong>In treatment-refractory schizophrenia (TRS), a predose plasma concentration of 0.35 mg L -1 is suggested to ensure an adequate trial of clozapine, but the target range may differ between smokers and nonsmokers.</p><p><strong>Method: </strong>We studied data from a clozapine therapeutic drug monitoring service, 1993-2017, with respect to age, sex, smoking status, clozapine dose, estimated clozapine treatment duration, plasma clozapine and norclozapine concentrations, and reason for the request.</p><p><strong>Results: </strong>There were 35,147 and 88,279 samples from 8882 women and 20,378 men, respectively, for which reasons for the request were specified (26,572 samples, 2 reasons; 6421, 3 or more reasons). More samples were sent for analysis due to suspected adverse drug reactions (ADRs) from women (5.3 vs 4.7%, P  < 0.001). The median minimum duration of clozapine treatment before the suspected reaction was 156 days shorter in nonsmokers than smokers of either sex ( P  < 0.001) and shorter in female than male nonsmokers (189 vs 334 d; P  < 0.01). The differences in median plasma clozapine concentrations between suspected ADR (1869/4149 samples from women/men, respectively), and control (10,627/25,848 samples from women/men, respectively) groups were small, averaging 0.03 mg L -1 ( P  < 0.01), but the median plasma clozapine in the ADR and baseline groups was 0.15 mg L -1 lower in smokers than nonsmokers ( P  < 0.001).</p><p><strong>Implications: </strong>The target ranges associated with response to clozapine and minimal ADRs in TRS may be 0.35-0.45 and 0.50-0.60 mg L -1 in smokers and in nonsmokers, respectively. ADRs may occur earlier in treatment in nonsmokers, particularly in women, who in general have higher predose plasma clozapine concentrations than men.</p>","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"336-344"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811647","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":"Reply to Letter From Surekha et al: \"Lumateperone for Mixed Features in MDD and Bipolar Depression: Advancing Treatment or Raising New Questions\".","authors":"Suresh Durgam, Susan G Kozauer, Willie R Earley, Changzheng Chen, Jason Huo, Hassan Lakkis, Stephen Stahl, Roger S McIntyre","doi":"10.1097/JCP.0000000000002019","DOIUrl":"10.1097/JCP.0000000000002019","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"409-410"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181850","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-Standing Akathisia Associated With Long-Acting Injectable Aripiprazole: A Case Report.","authors":"Kaitlyn Cox, Demetra Pantelis, Julio Cesar Pena, Jennifer Yehl","doi":"10.1097/JCP.0000000000002006","DOIUrl":"10.1097/JCP.0000000000002006","url":null,"abstract":"","PeriodicalId":15455,"journal":{"name":"Journal of Clinical Psychopharmacology","volume":" ","pages":"399-401"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780002","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}