Pharmacopsychiatry最新文献

{"title":"Association of Physical Activity and Bone Mineral Density in Adults with Depressive Symptoms.","authors":"Shakila Meshkat, Qiaowei Lin, Vanessa K Tassone, Reinhard Janssen-Aguilar, Wendy Lou, Venkat Bhat","doi":"10.1055/a-2645-4309","DOIUrl":"https://doi.org/10.1055/a-2645-4309","url":null,"abstract":"<p><p>Depression affects a significant proportion of adults in the United States. Studies exploring the association between depression and bone mineral density (BMD) have shown mixed results. Moreover, the relationship between BMD and physical activity (PA) in individuals with depressive symptoms is unknown. In this paper, we evaluated the association of depressive symptoms and PA with BMD, as well as difference in BMD among females with depressive symptoms before and after menopause.Data from the 2011-2018 National Health and Nutrition Examination Survey were used. Multivariable linear regression was used to explore the relationship between BMD and exposure variables.The study included 9,238 participants, of whom 766 had depressive symptoms. The presence and severity of depressive symptoms were significantly associated with lower BMD (aCoef.=-0.0200 for depressive symptoms, -0.0017 for depressive symptom severity; <i>p</i><0.001). Vigorous PA intensity was positively correlated with BMD, with and without controlling for depressive symptoms (aCoef.=0.0006; CI=[0.0003, 0.0008]; <i>p</i><0.001). Additionally, high levels of vigorous PA showed a significant positive relationship with BMD (aCoef.=0.0141; CI=[0.0078, 0.0205]; <i>p</i><0.001). Postmenopausal status was significantly associated with lower BMD. No significant interaction effects were observed between depressive symptoms and PA or menopausal status on BMD.Our study demonstrated the an association between depressive symptoms and low BMD, as well as a positive association between high-intensity vigorous PA and BMD. Future studies should aim to replicate our findings and evaluate the underlying mechanisms.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699218","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":"Investigation of Stress-Induced Cortisol Effects on Decision Making After Pharmacological Mineralocorticoid or Glucocorticoid Receptor Blockade.","authors":"Christian E Deuter, Theresa-Svea Weiß, Linn K Kuehl, Christian Otte, Katja Wingenfeld","doi":"10.1055/a-2646-7444","DOIUrl":"https://doi.org/10.1055/a-2646-7444","url":null,"abstract":"<p><p>Acute stress, potentially mediated by the stress-induced release of cortisol, affects decision-making processes. In the brain, cortisol activates two different types of receptors: the glucocorticoid receptor (GR) and the mineralocorticoid receptor (MR), each with different functional profiles. While previous studies suggest specific effects for MR and GR, the role of both receptor types in decision-making is insufficiently investigated.In this study, stress-induced effects of cortisol on decision-making processes were investigated after pharmacological receptor blockade of the MR (spironolactone, 300 mg) or the GR (mifepristone, 600 mg) in 318 healthy men (M=25.42, SD=5.01). After single-dose administration, participants were subjected to a social-evaluative stress task (Trier Social Stress Test, TSST), which reliably activates the HPA-axis, or a non-stressful control task (pTSST). Participants were randomly assigned to one study group: pTSST-placebo, TSST-placebo, TSST-spironolactone, or TSST-mifepristone. Subsequently, participants completed the Iowa Gambling Task (IGT) as an outcome measure. A mediation analysis was conducted to investigate direct effects of experimental manipulation in this study and indirect effects mediated by cortisol levels. The evidence for stress effects on decisions under ambiguity was positive.While stressed participants exhibited higher risk-taking, this was not the case in the TSST-spironolactone group, although this group had the most pronounced cortisol stress response. Thus, cortisol did not mediate this effect.The stress effect on decision-making was attenuated when MR was blocked. This corresponds to previous findings of increased risk-taking after MR activation and highlights a functional differentiation of both receptors for this domain.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699219","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":"Is Lumateperone Effective in Bipolar Depression? A Systematic Literature Review and Meta-Analysis on Placebo-Controlled Trials.","authors":"Maurizio Pompili, Mariarosaria Cifrodelli, Maria Anna Trocchia, Ludovica Longhini, Anna Comparelli, Roger S McIntyre, Isabella Berardelli","doi":"10.1055/a-2579-9406","DOIUrl":"https://doi.org/10.1055/a-2579-9406","url":null,"abstract":"<p><p>Bipolar depression is often difficult to treat and needs a specific therapeutic approach. This systematic review and meta-analysis aimed to evaluate the efficacy of lumateperone to be inclusive of more recently published studies with this agent in depressive episodes of bipolar disorder. Three meta-analyses were conducted to determine whether the mean Montgomery-Asberg Depression Rating Scale (MADRS) values in the placebo groups differ significantly from the mean MADRS scale values in the group receiving lumateperone 42 mg and whether the mean of Clinical Global Impression Bipolar Version - Severity Scale (CGI-BP-S) - (depression subscore and overall bipolar illness) values in the placebo groups differ significantly from the mean CGI-BP-S scale values in the group receiving lumateperone 42 mg. The meta-analysis showed a statistically significant difference between patients treated with lumateperone 42 mg and those treated with placebo for the MADRS and CGI subscores. The clinical profile of lumateperone indicates that it is a established and highly efficacious treatment option for major depressive episodes associated with bipolar disorder.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637714","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":"Time-Dependent Effects of Metformin and Olanzapine on the Metabolic System.","authors":"Gizem Kurt, Seyda T Durhan, Mehmet Ak, Tulin Yanik","doi":"10.1055/a-2634-7726","DOIUrl":"https://doi.org/10.1055/a-2634-7726","url":null,"abstract":"<p><p>Second-generation antipsychotic drugs, such as olanzapine, have been associated with metabolic side effects including significant weight gain. Recent evidence suggests that this adverse effect may be attenuated by metformin.Male Wistar rats were chronically treated with olanzapine, together with or without metformin, for 7 and 14 weeks. Feeding behavior, food intake, and weight gain were recorded, as well as plasma leptin and triglyceride levels were measured. The expression of hypothalamic candidate genes, <i>Pomc</i> and <i>Npy</i>, involved in appetite and energy balance expressions' was assessed by quantitative real-time polymerase chain reaction.Olanzapine alone caused significant body weight gain, and the co-administration of metformin for 14 weeks lowered body weight and food intake compared with both the 7-week and control groups. Plasma triglyceride levels did not differ among groups. Leptin levels were significantly higher in the olanzapine-only group and were lower in both metformin-olanzapine groups, more promising in the early co-treatment with metformin. Compared to the control group, the hypothalamus of the olanzapine treatment group exhibited downregulated <i>Pomc</i> expression and upregulated <i>Npy</i> expression.Early co-treatment with metformin significantly mitigated olanzapine-induced weight gain and food intake, demonstrating its potential in preventing metabolic side effects when initiated at the beginning of antipsychotic therapy.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608997","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":"2001-2021 Comparative Persistence of Oral Antipsychotics in Patients Initiating Treatment: Superiority of Clozapine in Time-to-Treatment Discontinuation.","authors":"Alberto Parabiaghi, Alessia A Galbussera, Barbara D'Avanzo, Mauro Tettamanti, Ida Fortino, Angelo Barbato","doi":"10.1055/a-2437-4366","DOIUrl":"10.1055/a-2437-4366","url":null,"abstract":"<p><strong>Background: </strong>Continuous antipsychotic (AP) therapy is crucial for managing psychotic disorders, and its early interruption reflects the drug's failure. Real-world epidemiological research is essential for confirming experimental data and generating new research hypotheses.</p><p><strong>Methods: </strong>The persistence of oral APs in a large population sample from 2000 to 2021 was analyzed by comparing AP prescriptions over this period across four Italian provinces, using dispensing data linked via a record-linkage procedure among regional healthcare utilization databases. We calculated personalized daily dosages and assessed time-to-treatment discontinuation over a 3-month period for patients initiating AP treatment. Treatment persistence was evaluated using Kaplan-Meier curves and Cox regression, with adjustments for age and sex.</p><p><strong>Results: </strong>Second-generation antipsychotics (SGAs) were favored over first-generation antipsychotics (FGAs), with olanzapine as the most prescribed. Within the study time frame, 42,434 individuals were prescribed a new continuous AP regimen. The analysis revealed 24 significant differences within 28 comparisons. As a class, SGAs demonstrated better treatment persistence than FGAs (HR: 0.76; 95%CI: 0.73, 0.79). Clozapine stood out for its superior persistence, surpassing all other SGAs, notably olanzapine (HR: 0.85; 95%CI: 0.79-0.91) and risperidone (HR: 0.80; 95%CI: 0.74-0.87). Olanzapine and aripiprazole showed better results than both risperidone and quetiapine. Quetiapine showed inferior 3-month persistence in all pairwise comparisons.</p><p><strong>Conclusion: </strong>The study results provide insight into the performance dynamics among SGAs: clozapine, despite being one of the less frequently dispensed APs in our sample, emerged as a significant prescription choice. The significance of pharmacoepidemiological studies in complementing experimental findings is also underscored.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"159-169"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625734","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":"Challenges Related to the Implementation of Measurement-Based Care for the Treatment of Major Depressive Disorder: A Feasibility Study.","authors":"Emytis Tavakoli, Angela Xiang, Mohamed I Husain, Daniel M Blumberger, Stefan Kloiber, Daniel J Mueller, Abigail Ortiz, Athina Perivolaris, Benoit H Mulsant","doi":"10.1055/a-2508-5757","DOIUrl":"10.1055/a-2508-5757","url":null,"abstract":"<p><p>Measurement-based care (MBC) involves systematically assessing patients' symptoms and adverse events using standardized scales to guide treatment. While MBC has been shown to enhance the quality of care and outcomes in the pharmacotherapy of major depressive disorder (MDD), it is still rarely used in clinical practice. In this study, the feasibility of implementing MBC was assessed for patients with MDD seen in a large outpatient psychiatry clinic.Adults diagnosed with MDD were assessed at baseline and during a 12-week follow-up by phone or via emailed links with: the 9-item Patient Health Questionnaire (PHQ-9), an adverse effect rating scale, and a published suicide risk management protocol (SRMP). Antidepressants were recommended based on preferences expressed by the participant and treating psychiatrist; dosages were adjusted by the treating psychiatrist based on symptomatic improvement and adverse events.Over 2 years, 52 (21.2%) of 246 patients referred to the study were enrolled, 28 (53.8%) completed all assessments at all follow-up visits, 45 (87.0%) participants were prescribed one of the recommended antidepressants, and 22 (42.3%) remitted. Of the 27 participants presenting with suicidal ideation, 18 (66.6%) experienced a full resolution of these ideations.These findings highlight the challenges in implementing MBC for the pharmacotherapy of MDD and confirm some barriers to its broad adoption in clinical practice. The study also highlights its benefits in the selected group of patients who engage in MBC. Future studies need to continue to explore innovative ways to facilitate its broader implementation.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"170-177"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143503135","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":"Regulatory Alignment of Psilocybin Clinical Trials in Major Depressive Disorder on ClinicalTrials.gov: A Cross-Sectional Analysis.","authors":"Damian Swieczkowski, Aleksander Kwaśny, Michal Pruc, Zuzanna Gaca, Lukasz Szarpak, Wiesław J Cubała","doi":"10.1055/a-2529-7029","DOIUrl":"10.1055/a-2529-7029","url":null,"abstract":"<p><p>Regulatory compliance is crucial in the clinical development of psychedelic substances, including psilocybin. This study aimed to examine the alignment of clinical trial protocols for psilocybin in the treatment of major depressive disorder (MDD) and treatment-resistant depression (TRD) with established regulatory requirements.A cross-sectional investigation was conducted on ClinicalTrials.gov using the keywords: \"Psilocybin\" and \"Psilocin\" to identify interventional studies with posted trial protocols. Only protocols for MDD and TRD were included. Data extraction focused on key regulatory aspects, including safety, functional unblinding, expectancy bias, and the distribution of investigational medical products.Eleven psilocybin trial protocols were identified, with four meeting the inclusion criteria. The most commonly studied psilocybin dose was 25 mg. Two trials were double-blind. Although the analyzed protocols superficially adhered to regulatory requirements, there were gaps in addressing potential drug interactions, the acute and chronic concurrent use of antidepressants, and prohibited medications. Certain aspects, such as functional unblinding or expectancy bias, did not share all pathways. Risk mitigation strategies were primarily based on external criteria. Patients with bipolar spectrum disorders or schizoaffective disorders were excluded.This study underscores the importance of conducting clinical trials on psychedelics in strict adherence to regulatory standards. Future research should focus on improving regulatory compliance and exploring the efficacy of psychedelics in broader patient populations.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"187-197"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005147","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":"Instruments Assessing Medication Literacy in Psychiatric Patients and the Caregivers: A Systematic Review.","authors":"Wan F H Wan Mohd Johari, Dayang F Abang Ma'mon, Izyan A Wahab, Nurul A Bahruddin, Noorasyikin Shamsuddin","doi":"10.1055/a-2591-2089","DOIUrl":"10.1055/a-2591-2089","url":null,"abstract":"<p><p>This systematic review investigates the instruments measuring medication literacy (ML) in psychiatric patients and their caregivers. Despite the critical role of ML in ensuring adherence to medication regimens, especially in populations with mental health conditions, existing instruments lack comprehensive validation of their measurement properties. This review identifies and assesses four instruments designed for psychiatric populations based on COSMIN guidelines. The findings reveal significant gaps in the validity and reliability of these tools. The review underscores the necessity for developing new, robust ML instruments tailored to people with mental illnesses and their caregivers to enhance clinical practice and patient outcomes. The results help to inform future psychiatry research and its clinical applications, promoting better medication management and improving adherence towards overall management in psychiatric care settings.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"178-186"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226155","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":"Diversion and Abuse of Prescribed Methylphenidate - A Survey of an Outpatient Clinic for Adult Persons with ADHD.","authors":"Mona Abdel-Hamid, Naomi Lyons, Michael Specka, Claudia Bartels, Michael Belz, Philipp Hessmann, Henrike Schecke, Thomas Zwarg, Norbert Scherbaum","doi":"10.1055/a-2545-1286","DOIUrl":"10.1055/a-2545-1286","url":null,"abstract":"","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"198-199"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731197","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":"Influence of Glutamate Neurotransmission Genes on the Outcomes of Antipsychotic Treatments.","authors":"Marc Cendrós, Rosa Catalán, Mercè Torra, Rafael Penadés, Alexandre González-Rodríguez, Mercè Brunet, Josefina Perez-Blanco, Natalia Cullell, Alexandre Serra-Llovich, Marta H Hernandez, María J Arranz","doi":"10.1055/a-2603-0871","DOIUrl":"https://doi.org/10.1055/a-2603-0871","url":null,"abstract":"<p><p>Traditionally, the aetiology of schizophrenia has been attributed to dopaminergic neurotransmission, but more recent information points to the role of glutamate pathways. Glutamatergic involvement in schizophrenia might be extensible to drug response. The aim of the study was to explore whether the variation in glutamate receptors, transporters and metabolism can influence the outcome of drug treatments.A total of 45 polymorphisms in the genes GRIN1, GRIN2A, GRIN2B, GRIN3A, GRIA1, GRIK2, GRM2, GRM3, GRM5, GRM8, SLC1A1, SLC1A3 and GAD1 were genotyped in 258 patients with schizophrenia. Efficacy and side effects were evaluated with the Positive and Negative Symptoms Scale and the UKU scale, respectively, at baseline and after 12 weeks.The analysis revealed associations between outcomes, including response and adverse effects and genetic variants in several genes (GAD1, GRIA1, GRIN2A, GRIN3A, GRIK2, GRM2, GRM5, GRM8 and SLC1A3). An association of rs1864205 in GRIA1 with autonomic side effects bordered statistical significance after correction for multiple comparisons.Our results suggest that genetic variation in glutamatergic pathways can influence the efficacy and safety of antipsychotic drugs.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317580","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}