Neuropsychopharmacology Reports最新文献

{"title":"Associations of TNF-α Expression With Self-Esteem in Autism Spectrum Disorder.","authors":"Yoshinori Kayashima, Takahira Yamauchi, Tsutomu Takeda, Kazuki Okumura, Rio Ishida, Kazuhiko Yamamuro, Michihiro Toritsuka, Takashi Okada, Nakao Iwata, Manabu Makinodan","doi":"10.1002/npr2.70047","DOIUrl":"10.1002/npr2.70047","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to explore the relationship between self-esteem and tumor necrotic factor-alpha (TNF-α) expression in individuals with autism spectrum disorder (ASD). Self-esteem was assessed using the Contingencies of Self-Worth (CSW) scale, with a focus on external and internal contingencies, and TNF-α expression was measured, given its association with both ASD pathophysiology and self-esteem in prior studies.</p><p><strong>Methods: </strong>We enrolled 51 high-functioning individuals with ASD and 34 typically developed (TD) individuals. Self-esteem was assessed using the Japanese version of the CSW scale, which evaluates seven domains, and the Personal Sense of Power. TNF-α expression in plasma was quantified via ELISA. Correlations of CSW scores and the Personal Sense of Power with TNF-α levels were analyzed using multiple regression models adjusted for confounding factors such as age, sex, education level, and autistic symptoms.</p><p><strong>Results: </strong>In ASD individuals, TNF-α expression was significantly negatively correlated with the external CSW domain of others' approval and showed a trend toward negative correlations with appearance and relationship harmony. These correlations were not observed in the TD individuals. Likewise, the Personal Sense of Power within family settings showed a trend toward positive correlations with TNF-α expression in ASD individuals, but not in TD individuals.</p><p><strong>Discussion: </strong>This study highlights the implication of TNF-α levels in the self-esteem of ASD individuals, particularly in interpersonal relationships. Lower TNF-α expression was associated with higher self-esteem in social contexts, independent of the severity of autistic symptoms. These findings suggest a biological link between inflammatory pathways and self-esteem in ASD, contributing to a deeper understanding of the interplay between immune function and psychological well-being in this population.</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"45 4","pages":"e70047"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Possible Involvement of Hallucinogenic Effects in the Aversive Effects Induced by Kappa-Opioid and 5-HT_2A _/2C Receptor Agonists in Mice.","authors":"Hideaki Kato, Yoshimi Ichimaru, Masaaki Kurihara, Koushirou Sogawa, Masahiko Funada, Tsutomu Suzuki","doi":"10.1002/npr2.70075","DOIUrl":"10.1002/npr2.70075","url":null,"abstract":"<p><strong>Aim: </strong>The regulation of new psychoactive and dangerous abused substances is very important for the prevention of drug abuse. A simple and effective evaluation method using laboratory animals is needed to regulate designated drugs with high accuracy and speed.</p><p><strong>Methods: </strong>In the present study, we used the typical κ-opioid receptor agonist U50,488H and the typical 5-HT_2A/2C receptor agonist 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane hydrochloride (DOI), which have a similar mechanism of action to hallucinogenic drugs, in a conditioned place aversion (CPA) test in mice. In addition, because hallucinogenic drugs can cause emotional abnormalities during hallucinations, we performed a marble-burying test in mice.</p><p><strong>Results: </strong>In the CPA test, both κ-opioid receptor and 5-HT_2A/2C receptor agonists produced significant aversive effects and abnormal behavior. These aversive effects and abnormal behavior were probably due in part to the hallucinogenic effects of these drugs.</p><p><strong>Conclusion: </strong>Therefore, these tests using mice may be useful for evaluating hallucinogenic effects. We hope that these simple and rapid evaluation methods will be used to identify designated drugs.</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"45 4","pages":"e70075"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12640738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Impact of EGUIDE Training on Facility-Wide Guideline Adherence Rate in Schizophrenia and Major Depressive Disorder: A Multicenter Study.","authors":"Naomi Hasegawa, Hiroyuki Muraoka, Yusuke Arai, Toru Horinouchi, Kazuhiro Yamamuro, Naoki Hashimoto, Shinichiro Ochi, Takashi Tsuboi, Yasushi Kawamata, Toshinori Nakamura, Yuka Yasuda, Junya Matsumoto, Satsuki Ito, Toshiaki Onitsuka, Kazutaka Ohi, Shusuke Numata, Hikaru Hori, Ken Inada, Koichiro Watanabe, Norio Yasui-Furukori, Ryota Hashimoto","doi":"10.1002/npr2.70067","DOIUrl":"10.1002/npr2.70067","url":null,"abstract":"<p><strong>Objective: </strong>The Effectiveness Research on the Dissemination and Education of Psychiatric Clinical Practice Guidelines (EGUIDE Project) was launched in Japan to promote guideline-adherent treatment for schizophrenia and major depressive disorder (MDD) through educational outreach programs. Although short-term effects on participating physicians have been reported, the long-term and facility-wide effects remain unclear. This study evaluated whether guideline-compliant treatment behaviors improved across institutions over time, indicating potential diffusion or spillover effects.</p><p><strong>Methods: </strong>We conducted a prospective observational study involving 298 psychiatric facilities between 2016 and 2023. Discharge prescriptions and treatment data were collected for 19 623 patients with schizophrenia and 9805 patients with MDD. Adherence to the guidelines was assessed using 11 schizophrenia quality indicators (QI-S) and seven MDD quality indicators (QI-D). We performed logistic regression analyses, adjusting for age, sex, and facility type, with Bonferroni correction for multiple comparisons.</p><p><strong>Results: </strong>For schizophrenia, significant year-on-year improvements were observed in seven of the 11 QI-S, including assessment of treatment-resistant schizophrenia (TRS) diagnosis (from 42.2% to 62.5%), use of modified electroconvulsive therapy (mECT; from 6.1% to 11.8%), and nonprescription of anticholinergics (from 70.7% to 81.7%). For MDD, three of the seven QI-D showed improvement, including assessment of severity diagnosis (from 51.2% to 77.0%) and use of mECT (from 12.8% to 26.6%). Notably, the implementation of cognitive behavioral therapy (CBT) decreased. These findings suggest long-term behavioral changes across all facilities, extending even to nonparticipating clinicians.</p><p><strong>Conclusion: </strong>The presence of EGUIDE-trained psychiatrists was associated with sustained improvements in guideline-compliant treatments at the institutional level. These results imply not only individual educational benefits but also a diffusion of practice culture-that is, a spillover effect-leading to enhanced quality of psychiatric care. Continued educational efforts are essential to improving treatment practices at scale.</p><p><strong>Trial registration: </strong>The protocol for the EGUIDE Project is registered with the University Hospital Medical Information Network Registry (UMIN000022645).</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"45 4","pages":"e70067"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12560011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145377978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Associations of Serum Orexin-A With Physical Activity and Sleep in Schizophrenia: A Preliminary Study.","authors":"Akira Tanaka, Yusuke Arai, Takehiko Yasaki, Kentaro Saito, Erika Nakashizuka, Shinsuke Yoshida, Yuka Nakajima, Mika Koido, Kazuhiro Suzuki, Toshinori Nakamura, Daimei Sasayama, Shinsuke Washizuka","doi":"10.1002/npr2.70079","DOIUrl":"10.1002/npr2.70079","url":null,"abstract":"<p><strong>Aim: </strong>Orexin-A (OXA) is a neuropeptide that regulates arousal, behavior, and sleep-wake rhythms. While altered OXA levels have been observed in schizophrenia, longitudinal data are limited. This study examined the relationship between changes in serum OXA levels and physical activity, sleep, and psychiatric symptoms in patients with chronic schizophrenia.</p><p><strong>Methods: </strong>Seventeen long-term inpatients with schizophrenia underwent assessments at baseline (T1) and again after 6 months (T2). Serum OXA levels, sleep and activity parameters derived from actigraphy, and psychiatric symptoms (evaluated with the Positive and Negative Syndrome Scale [PANSS]) were collected at both time points. Spearman's correlations were used to analyze associations between the T2-T1 change in serum OXA (ΔOXA) and the corresponding Δ values of each sleep, activity, and PANSS measure, to explore longitudinal associations among these variables.</p><p><strong>Results: </strong>ΔOXA was positively correlated with Δ step count (ρ = 0.53, p = 0.03) and negatively correlated with Δ time in bed (ρ = -0.50, p = 0.04). No significant associations were found with PANSS scores, other sleep parameters, pharmacotherapy, or body mass index.</p><p><strong>Conclusion: </strong>In this preliminary longitudinal sample, increases in serum OXA were linked to greater daytime activity and reduced time in bed, suggesting that orexinergic signaling may modulate behavioral regulation in schizophrenia beyond its established role in sleep-wake control. Larger studies, with adjustment for multiple comparisons, are warranted to evaluate OXA as a candidate biomarker or therapeutic target.</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"45 4","pages":"e70079"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145636773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a Linguistically Valid Japanese Version of the Chronic Pain Attribution Scale: Translation and Cultural Adaptation Process.","authors":"Keiko Yamada, Akihiro Yamamoto, Keita Ueno, Yukari Takahashi, Masaya Ueda, Hui Ming Khoo, Koichi Hosomi, Ryouhei Ishii, Fusao Kato","doi":"10.1002/npr2.70064","DOIUrl":"10.1002/npr2.70064","url":null,"abstract":"<p><strong>Background: </strong>Patients' \"pain attributions,\" or their beliefs about chronic pain causes, critically affect pain experience and recovery, potentially modulating responses to analgesics and psychotropics. Since many pain-mitigating drugs also impact psychological processes and brain functions underlying these attributions, such processes are relevant targets. The Chronic Pain Attribution Scale (CPAS) by Ashar et al. (2023) quantifies these beliefs. A Japanese version (CPAS-J) is needed to assess this psychologically relevant construct in Japanese populations. This study aimed to develop and linguistically validate the CPAS-J.</p><p><strong>Methods: </strong>The CPAS-J was developed following International Society for Pharmacoeconomics and Outcomes Research guidelines, with permission from the original author. The process included forward translation by eight bilingual medical experts, reconciliation by a pain research team, back-translation by an independent translator, review by the original author, and a final consensus discussion to establish the definitive CPAS-J.</p><p><strong>Results: </strong>The linguistic validation identified challenges in distinguishing \"cause\" from \"trigger\" in Japanese. To enhance comprehensibility, the team combined \"kikkake\" (initiating factor) and \"gen'in\" (broader cause/origin). The finalized CPAS-J assesses perceived causes of pain.</p><p><strong>Conclusions: </strong>The CPAS-J was successfully developed through a rigorous process. This tool supports research on pain attributions in Japanese-speaking populations and may improve our understanding of treatment responses by assessing a key psychological dimension of chronic pain that is linked to brain-based processes.</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"45 4","pages":"e70064"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of N-Acetylcysteine (NAC) on Neurometabolites and Cognitive Function in Adults With Alcohol Use Disorder: A Preliminary Randomized Controlled Trial.","authors":"Kristiane Yacou Dunbar, Gezelle Dali, Marilena M DeMayo, Warren Logge, Tristan Hurzeler, Catherine Kelly, Joshua Watt, Lindsay M Squeglia, Anna E Kirkland, Paul S Haber, Kirsten C Morley","doi":"10.1002/npr2.70066","DOIUrl":"10.1002/npr2.70066","url":null,"abstract":"<p><strong>Background and aims: </strong>Preclinical studies have demonstrated that N-acetylcysteine stabilizes levels of glutamate and glutathione and reduces alcohol-seeking behaviors, indicating it as a potential pharmacotherapy for the management of alcohol use disorder. In this preliminary study, we examined brain metabolite levels and cognitive functioning in individuals with alcohol use disorder enrolled in a randomized controlled trial of N-acetylcysteine versus placebo.</p><p><strong>Methods: </strong>In this preliminary trial, 23 participants (average age = 49; 70% male) with moderate to severe alcohol use disorder (DSM-5) were randomized to receive 2400 mg/day of N-acetylcysteine (N = 9) or placebo (N = 14). At baseline and follow-up (M = 19 days; SD = 3.73 days post-baseline), participants underwent proton magnetic resonance spectroscopy (¹H-MRS) to assess levels of glutamate (Glu), glutathione (GSH) and total N-acetylaspartate (tNAA) in the anterior cingulate cortex (ACC) and completed the Stroop Color and Word Test (SCWT; a measure of distractor interference and cognitive control) and the Trail Making Test (TMT; a measure of set shifting ability).</p><p><strong>Results: </strong>There were no significant differences between the N-acetylcysteine or placebo groups in neurometabolite concentrations (GSH/Cr: p = 0.75, CI; -0.12-0.09, tNAAG/Cr: p = 0.797, CI; -0.10-0.13, Glu/Cr: p = 0.60, CI; -0.19-0.32), or cognitive scores (Stroop: p = 0.57, CI; -306.93-172.78, TMT: p = 0.166, CI; -6.62-36.77).</p><p><strong>Conclusion: </strong>These preliminary findings indicate that N-acetylcysteine may not alter brain neurometabolite levels within the ACC or show improvements in certain domains of cognitive functioning measured by the SCWT and TMT, specifically resistance to distractor interference and set-shifting ability respectively, in individuals with alcohol use disorder.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT03879759.</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"45 4","pages":"e70066"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12548303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145346295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gray Matter Alterations and Symptom Severity in Forensic Psychiatric Patients: An Exploratory VBM Study.","authors":"Gaia Cartocci, Maddalena Boccia, Pieritalo Maria Pompili, Mariagiulia Tullo, Stefano Ferracuti, Paola Frati, Vittorio Fineschi, Marco Fiorelli, Francesca Caramia","doi":"10.1002/npr2.70070","DOIUrl":"10.1002/npr2.70070","url":null,"abstract":"<p><strong>Aim: </strong>The relationship between mental illness and criminal behavior is a critical social issue that remains under debate. This study aimed to investigate differences in cortical gray matter (GM) volume between mentally ill individuals institutionalized in a residence for the execution of security measures (REMS) following a violent offense-and deemed not criminally responsible due to their psychiatric condition-and a control group of healthy non-offenders, using voxel-based morphometry (VBM) analyses.</p><p><strong>Method: </strong>We recruited 13 male violent offenders with psychotic disorders institutionalized in REMS and 13 healthy controls. Psychiatric symptoms were assessed using the Brief Psychiatric Rating Scale (BPRS), and psychopathy traits with the Psychopathy Checklist-Revised (PCL-R). High-resolution structural Magnetic Resonance scans were acquired on a 3T scanner. VBM analyses were used to identify GM volume differences between groups, and correlation analyses were performed to assess associations between brain structure and clinical measures.</p><p><strong>Results: </strong>The experimental group showed wide variability in symptom severity and psychopathy traits. VBM analyses revealed GM volume reductions in bilateral insular cortex, in left superior temporal gyrus (STG) and right fusiform gyrus (FG) of the experimental group. GM volume in the left STG-insula cluster significantly correlated with BPRS scores. No significant associations were found with PCL-R scores.</p><p><strong>Conclusion: </strong>These findings highlight structural brain alterations associated with psychotic symptomatology and should serve as a starting point for future research exploring the neural changes associated of pathological social behavior in mentally ill persons who committed violent crimes.</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"45 4","pages":"e70070"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12631019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Possible Effect of Governmental Restrictions of Benzodiazepine Prescriptions on Suicide Attempts by Overdose of Prescribed Psychotropic Drugs in Japan.","authors":"Akihisa Akahane, Kenichi Matsumura, Yukari Mashiko, Rie Kanai, Hiroshi Kunugi","doi":"10.1002/npr2.70068","DOIUrl":"10.1002/npr2.70068","url":null,"abstract":"<p><strong>Purpose: </strong>Suicide attempt by overdose medication of benzodiazepine is common. In Japan, governmental restrictions on benzodiazepine multidrug use started as of 2012, resulting in a decrease in benzodiazepine prescriptions and multidrug use. This study aimed to examine whether suicide attempts due to overdose medication of psychotropic drugs decreased after this regulation.</p><p><strong>Methods: </strong>We retrospectively obtained information from clinical records for 4183 and 4140 patients admitted to the intensive care unit of the Advanced Emergency Medical Center at Teikyo University Hospital, Tokyo, during the 2-year period from April 2013 to March 2015 (immediately after the introduction of the regulation: Period 1) and from April 2018 to March 2020 (after the enhancement of the regulations: Period 2), respectively. The proportion of patients who attempted suicide, that of overmedication with prescribed psychotropic drugs, and their clinical characteristics were compared between the two periods.</p><p><strong>Results: </strong>The proportion of patients with suicide attempts by psychotropic overdose medication in Period 1 was 4.1%, whereas it decreased significantly to 2.8% in Period 2 (p = 0.004). The mean (standard deviation) diazepam-equivalent daily prescription for those overdosing was 32.0 (33.3) mg in Period 1, compared to 25.6 (30.0) mg in Period 2, a significant decrease (p = 0.01). The mean number of concomitant benzodiazepines also decreased significantly from 2.8 (1.4) to 2.0 (1.0) (p = 0.0002).</p><p><strong>Conclusions: </strong>Our results suggest that the governmental regulation to control multidrug use of benzodiazepine prescriptions in Japan reduced the number and doses of benzodiazepines prescribed and decreased suicide attempts by overdose medication of prescribed psychotropic drugs.</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"45 4","pages":"e70068"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12685563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145708750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Atypical Antipsychotics With Lipid Abnormalities in Adult Patients With Schizophrenia: A Scoping Review.","authors":"Virginia Abavana, Soban Sadiq","doi":"10.1002/npr2.70042","DOIUrl":"10.1002/npr2.70042","url":null,"abstract":"<p><strong>Background: </strong>Atypical antipsychotics (AAs) are commonly used in the treatment of schizophrenia and are often preferred as first-line therapy over typical antipsychotics (TAs) due to their lower risk of extrapyramidal side effects. Both groups are efficacious in treating symptoms of schizophrenia, but increasing research has highlighted AAs as being associated with a risk of developing dyslipidaemia. Existing research has pointed to the need for more data focusing on the effects of individual AAs on dyslipidaemia in this population.</p><p><strong>Methods: </strong>The scoping review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping reviews (PRISMA-ScR) checklist. The thematic analysis was used to synthesize data from 12 studies selected through structured searches across six databases. Inclusion criteria focused on primary studies between 2015 and 2025 involving adult patients with schizophrenia (18-65 years) treated with AAs and reporting on lipid abnormalities. The themes were identified via Braun and Clarke's six-step framework.</p><p><strong>Results: </strong>Clozapine and olanzapine were most strongly associated with increased LDL, total cholesterol, and triglycerides, and reduced HDL. Aripiprazole and lurasidone showed minimal impact. Identified biomarkers included asprosin, IGFBP-2, MIF, and white blood cell counts. Pharmacogenetic markers such as APOA1 gene polymorphisms and specific SNPs were also linked to lipid profile variability. Anthropometric indicators like waist-to-hip ratio were correlated with dyslipidaemic risk.</p><p><strong>Conclusion: </strong>The review shows significant associations between specific AAs and lipid abnormalities, particularly with clozapine and olanzapine. Biomarkers and genetic polymorphisms offer promising avenues for monitoring and personalized treatment. Evidence for certain AAs, such as amisulpride, paliperidone, and ziprasidone, remains sparse, highlighting the need for further targeted research. These findings support informed prescribing and the development of predictive tools to mitigate metabolic risks in the treatment of schizophrenia.</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"45 4","pages":"e70042"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Effectiveness of Yokukansan and Lemborexant as Alternative Candidates to Benzodiazepines to Prevent Benzodiazepine Withdrawal Delirium in the Cancer Perioperative Period: A Case Report and Literature Review.","authors":"Junji Yamaguchi, Ryoichi Sadahiro, Saho Wada, Eri Nishikawa, Tatsuto Terada, Rika Nakahara, Hiromichi Matsuoka","doi":"10.1002/npr2.70062","DOIUrl":"10.1002/npr2.70062","url":null,"abstract":"<p><strong>Background: </strong>Benzodiazepine withdrawal delirium is a serious problem, and several candidates have been proposed to manage benzodiazepine withdrawal, such as valproic acid and carbamazepine, up to now. However, it is not always possible to use these candidates during the cancer perioperative period due to the risk of oversedation, and new candidates are being awaited.</p><p><strong>Case presentation: </strong>A woman in her late 80s was prescribed lorazepam 1.0 mg/day and brotizolam 0.25 mg/day for persistent anxiety and insomnia following the death of her husband and son. She had been receiving these medications for 3 years; however, they were ineffective, and she began consuming double the prescribed dose to manage her symptoms. Additionally, problematic drinking behavior was also acknowledged. Three months before the cancer surgery, the first author and her primary physician collaborated; lorazepam was gradually reduced to 0.5 mg/day, while yokukansan (5.0 g/day) and lemborexant (5.0 mg/day) were introduced instead. Her mental status stabilized, and surgery was performed as planned with no adverse effects. Postoperative and benzodiazepine withdrawal delirium were not observed.</p><p><strong>Conclusion: </strong>The combination of yokukansan and lemborexant may be an effective replacement for benzodiazepines in terms of their effects on 5-hydroxytryptamine-related mechanisms and regulation of the sleep cycle. During the cancer perioperative period, physicians may consider the gradual replacement or reduction of benzodiazepines with yokukansan and lemborexant before the surgery to avoid possible benzodiazepine-related delirium.</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"45 4","pages":"e70062"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}