Pharmacopsychiatry最新文献_第2页

Cardiovascular Effects of Non-Selective Monoamine Oxidase Inhibitors and Intranasal Esketamine Combination in Depression - A Quasi-Experimental Design with Bayesian Analyses. 非选择性单胺氧化酶抑制剂和鼻内艾氯胺酮联合治疗抑郁症对心血管的影响——贝叶斯分析的准实验设计。

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-06-02 DOI: 10.1055/a-2590-3469

Ludovic C Dormegny-Jeanjean, Suzie Lenoir, Ilia Humbert, Olivier A E Mainberger, Coraline Lozere, Camille Meyer, Bernard Geny, Bruno Michel, Jack R Foucher, Clément de Crespin de Billy

{"title":"Cardiovascular Effects of Non-Selective Monoamine Oxidase Inhibitors and Intranasal Esketamine Combination in Depression - A Quasi-Experimental Design with Bayesian Analyses.","authors":"Ludovic C Dormegny-Jeanjean, Suzie Lenoir, Ilia Humbert, Olivier A E Mainberger, Coraline Lozere, Camille Meyer, Bernard Geny, Bruno Michel, Jack R Foucher, Clément de Crespin de Billy","doi":"10.1055/a-2590-3469","DOIUrl":"https://doi.org/10.1055/a-2590-3469","url":null,"abstract":"Ketamine and esketamine (ESK) offer new treatment options for resistant depression. Unlike traditional antidepressants, they can be used in combination with non-selective monoamine oxidase inhibitors (NS-MAOI) without the risk of serotonergic syndrome. However, potential sympathomimetic synergy may lead to elevated blood pressure (BP). This series investigates whether cardiovascular parameters (heart rate, systolic [SP], and diastolic [DP] pressures) increase during ESK sessions and whether the ESK+NS-MAOI combination is associated with BP elevations.We collected cardiovascular parameters for ESK sessions conducted between 2018 and 2022. These parameters were measured at baseline and every 30 min for 2 h. Patients were categorized into two non-equivalent groups: those receiving ESK alone and those receiving ESK+NS-MAOI. A Bayesian random model was used to estimate the evolution of these parameters, while a Bayesian hierarchical model assessed factors contributing to BP elevation.ESK sessions (n=193), of which 116 involved NS-MAOI, were performed in 13 patients. SP, DP, and heart rate showed peak increases during sessions, but these changes were not clinically significant (SP+8.68 mmHg, DP+6.57 mmHg, and heart rate+3.5 bpm). No significant differences were found between the ESK-alone and ESK+NS-MAOI groups. The combination was not identified as a factor linked to BP elevations.These findings align with previous research on ketamine derivatives and suggest minimal peripheric sympathomimetic synergy with NS-MAOI. Bayesian models were used to account for biases intrinsically related to these ecological data and provide a foundation for future open adversarial collaborations. Registration NCT05530668.","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209074","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}

引用次数: 0

Ensemble Machine Learning Model for Real-Time Valproic Acid Prediction in Epilepsy Treatment. 癫痫治疗中丙戊酸实时预测的集成机器学习模型。

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-06-02 DOI: 10.1055/a-2593-3125

Jiangchuan Xie, Pan Ma, Xinmei Pan, Liya Cao, Ruixiang Liu, Lirong Xiong, Hongqian Wang, Xin Zhang, Linli Xie, Yongchuan Chen

{"title":"Ensemble Machine Learning Model for Real-Time Valproic Acid Prediction in Epilepsy Treatment.","authors":"Jiangchuan Xie, Pan Ma, Xinmei Pan, Liya Cao, Ruixiang Liu, Lirong Xiong, Hongqian Wang, Xin Zhang, Linli Xie, Yongchuan Chen","doi":"10.1055/a-2593-3125","DOIUrl":"https://doi.org/10.1055/a-2593-3125","url":null,"abstract":"To develop an optimal model to predict valproic acid (VPA) concentrations by machine learning, ensuring that the VPA plasma concentration is in the effective treatment range, and thus effectively control the patient's epilepsy.This single-center, retrospective study included patients diagnosed with epilepsy from January 2014 to January 2022. Patients receiving VPA and having undergone therapeutic drug monitoring were enrolled. Top three algorithms exhibiting superior model performance were selected to establish the ensemble prediction model, with Shapley Additive exPlanations (SHAP) employed for model interpretation. An independent dataset was collected as a clinical validation group to verify the prediction model performance.The algorithms chosen for the ensemble model-Light Gradient Boosting, Categorical Boosting, and Gradient Boosted Regression Trees-demonstrated high R 2 (0.549, 0.515, and 0.503, respectively). Post-feature selection, the final model incorporated 20 variables, proving superior in predictive performance compared to models considering all 24 variables. The R 2 , mean absolute error, mean square error, absolute accuracy (±20 mg/L), and relative accuracy (±20%) of external validation were 0.621, 10.67, 221.50, 78.98%, and 66.48%, respectively. The importance and direction of each variable were visually represented using SHAP values, with VPA administration and liver function emerging as the most significant factors.The innovative application harnesses advanced multi-algorithm mining methodologies to forecast VPA concentrations in adult epileptic patients. Furthermore, it employs SHAP to elucidate the nuanced influence of each feature within the integrated prediction model, thereby providing a robust and plausible explanation for the determinants affecting VPA concentration predictions.","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209075","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}

引用次数: 0

Patient and Physician Exposure to Artificial Intelligence Hype. 病人和医生接触人工智能炒作。

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-05-12 DOI: 10.1055/a-2577-7214

Scott Monteith, Tasha Glenn, John R Geddes, Peter C Whybrow, Eric D Achtyes, Rita Bauer, Michael Bauer

引用次数: 0

Therapeutic Drug Monitoring of Cariprazine - Updated Values for a Dose-Related Reference Range. 卡吡嗪的治疗药物监测-剂量相关参考范围的更新值。

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-05-01 Epub Date: 2025-01-29 DOI: 10.1055/a-2511-3744

Fabian Sattaf, Maike Scherf-Clavel, Stefan Unterecker, Andreas Eckert, Andreas Reif, Martina Hahn

{"title":"Therapeutic Drug Monitoring of Cariprazine - Updated Values for a Dose-Related Reference Range.","authors":"Fabian Sattaf, Maike Scherf-Clavel, Stefan Unterecker, Andreas Eckert, Andreas Reif, Martina Hahn","doi":"10.1055/a-2511-3744","DOIUrl":"10.1055/a-2511-3744","url":null,"abstract":"Dose-related reference ranges can be used in therapeutic drug monitoring to monitor pharmacotherapy. The deviation of a measured serum concentration from the expected serum concentration at the corresponding dose can thus be identified early and responded to appropriately. The serum concentrations of patients treated with cariprazine regularly deviated from this dose-related reference range. As this is a relatively new drug with only one recommendation on values for a dose-related reference range, the values were tested for validity using real-world data.Serum concentrations of 24 patients receiving cariprazine once daily were analyzed retrospectively. Only patients without pharmacokinetic abnormalities were included. The measured serum concentrations were compared with the values of the dose-related reference range in the guidelines of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie consensus guidelines of 2017 and checked whether a sufficient number of serum concentrations were within the dose-related reference range.Only 45.8% of the measured serum concentrations were within the dose-related reference range. The C/D ratio was 1.58±0.73. Accordingly, a lower value of 0.85 and an upper value of 2.31 were calculated for the updated dose-related reference range, which is below the currently recommended values.The results suggest that the current values for the dose-related reference range are too high and require adjustment. The updated dose-related reference range lies between 0.85 and 2.31, with a mean of 1.58±0.73.","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"127-131"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067107","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}

引用次数: 0

Activation of Hippocampal Neuronal NADPH Oxidase NOX2 Promotes Depressive-Like Behaviour and Cognition Deficits in Chronic Restraint Stress Mouse Model. 激活海马神经元 NADPH 氧化酶 NOX2 可促进慢性束缚应激小鼠模型的抑郁样行为和认知缺陷

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-05-01 Epub Date: 2024-11-15 DOI: 10.1055/a-2429-4023

Zejie Zuo, Hongyang Zhang, Zhihui Li, Fangfang Qi, Haojie Hu, Junhua Yang, Zhibin Yao

{"title":"Activation of Hippocampal Neuronal NADPH Oxidase NOX2 Promotes Depressive-Like Behaviour and Cognition Deficits in Chronic Restraint Stress Mouse Model.","authors":"Zejie Zuo, Hongyang Zhang, Zhihui Li, Fangfang Qi, Haojie Hu, Junhua Yang, Zhibin Yao","doi":"10.1055/a-2429-4023","DOIUrl":"10.1055/a-2429-4023","url":null,"abstract":"Background: Nicotinamide adenosine dinucleotide phosphate oxidases (NOX) play important roles in mediating stress-induced depression. Three NOX isotypes are expressed mainly in the brain: NOX2, NOX3 and NOX4. In this study, the expression and cellular sources of these NOX isoforms was investigated in the context of stress-induced depression.Methods: Chronic restraint stress (CRS)-induced depressive-like behaviour and cognitive deficits were evaluated by tail suspension tests, forced swimming tests and the Morris water maze test. Hippocampal NOX expression was determined by immunofluorescence staining and western blotting. The hippocampal levels of the brain-derived neurotrophic factor (BDNF) mRNA were determined via quantitative real-time -polymerase chain reaction. Glucocorticoid levels in the hippocampus were measured using ELISA kits.Results: In the mouse CRS model, a significant increase in NOX2 expression was observed in the hippocampus, whereas no significant changes in NOX3 and NOX4 expression were detected. Next, NOX2 expression was primarily localised to neurons (NeuN+) but not microglia (Iba-1+) or astrocytes (GFAP+). Treatment with gp91ds-tat, a specific NOX2 inhibitor, effectively mitigated the behavioural deficits induced by CRS. The decreased expression of the BDNF mRNA in the hippocampus of CRS mice was restored upon gp91ds-tat treatment. A positive correlation was identified between neuronal NOX2 expression and serum glucocorticoid levels.Conclusions: Our study indicated that neuronal NOX2 may be a critical mediator of depression-like behaviours and spatial cognitive deficits in mice subjected to CRS. Blockade of NOX2 signalling may be a promising therapeutic strategy for depression.","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"117-126"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638740","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}

引用次数: 0

Development of a Genetic Test Indicating Increased AVP/V1b Signalling in Patients with Acute Depression. 急性抑郁症患者AVP/V1b信号增加的基因检测的发展

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-05-01 Epub Date: 2025-01-29 DOI: 10.1055/a-2508-5834

Marcus Ising, Florian Holsboer, Marius Myhsok, Bertram Müller-Myhsok

{"title":"Development of a Genetic Test Indicating Increased AVP/V1b Signalling in Patients with Acute Depression.","authors":"Marcus Ising, Florian Holsboer, Marius Myhsok, Bertram Müller-Myhsok","doi":"10.1055/a-2508-5834","DOIUrl":"10.1055/a-2508-5834","url":null,"abstract":"A subgroup of patients with acute depression show an impaired regulation of the hypothalamic-pituitary-adrenocortical axis, which can be sensitively diagnosed with the combined dexamethasone (dex)/corticotropin releasing hormone (CRH)-test. This neuropathological alteration is assumed to be a result of hyperactive AVP/V1b signalling. Given the complicated procedure of the dex/CRH-test, this study aimed to develop a genetic variants-based alternative approach to predict the outcome of the dex/CRH-test in acute depression.Using data of a representative cohort of 352 patients with severe depression participating in the dex/CRH-test, a genome-wide interaction analysis was performed starting with an anchor single nucleotide polymorphism located in the upstream transcriptional region of the human V1b-receptor gene to predict the adrenocorticotropic hormone (ACTH) response to this test. A probabilistic neural-network-algorithm was used to develop the optimal prediction model.Overall prediction accuracy for correctly identifying high ACTH responders in the dex/CRH-test was 93.5% (sensitivity 90%; specificity 95%). Analysis of pituitary RNAseq expression data confirmed that the identified genetic interactions of the gene test translate into an interactive network of corresponding transcripts in the pituitary gland, which is the biologically relevant target tissue, with the aggregated strength of the transcript interactions significantly stronger than expected from chance.The findings suggest the suitability of the presented gene test as a proxy for hyperactive AVP/V1b signalling during an acute depressive episode, highlighting its potential as companion test for identifying patients with acute depression whose pathology can be optimally treated by specific drugs targeting the AVP/V1b-signaling cascade.","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"132-138"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067104","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}

引用次数: 0

Pharmacological Treatment of Autism Spectrum Disorder: A Systematic Review of Treatment Guidelines. 自闭症谱系障碍的药物治疗：治疗指南的系统回顾。

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-05-01 Epub Date: 2025-01-31 DOI: 10.1055/a-2514-4452

Sota Tomiyama, Kazunari Yoshida, Hideaki Tani, Hiroyuki Uchida

{"title":"Pharmacological Treatment of Autism Spectrum Disorder: A Systematic Review of Treatment Guidelines.","authors":"Sota Tomiyama, Kazunari Yoshida, Hideaki Tani, Hiroyuki Uchida","doi":"10.1055/a-2514-4452","DOIUrl":"10.1055/a-2514-4452","url":null,"abstract":"Currently available systematic reviews on the pharmacological treatment of autism spectrum disorder (ASD) do not encompass all the evidence, as they exclude guidelines issued by national or local authorities that are not indexed in search engines such as PubMed.A systematic literature search was conducted to identify clinical guidelines on this topic using EMBASE, Medline, and PsycINFO. A manual search was also performed to identify guidelines by national or local authorities not included in the aforementioned databases.Thirty-eight guidelines were identified through manual search, including 27 items through search engines, 2 general guidelines, and 9 government agency guidelines. Many guidelines recommended risperidone (N=16) for the characteristic behaviors of ASD core features. For attention-deficit/hyperactivity disorder (ADHD) features, methylphenidate was most frequently recommended (N=23) for both inattention (N=6) and hyperactivity/impulsivity (N=16). Risperidone was also frequently recommended for maladaptive behaviors (N=33).A comprehensive literature search identified treatment guidelines for ASD issued by local or national administrative bodies that were not captured through search engines alone. There was some consensus among the guidelines on the use of psychotropics in alleviating specific features of ASD. However, physicians need to be aware of the lack of high-quality evidence supporting these recommendations.","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"100-116"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074580","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}

引用次数: 0

Therapeutic Reference Range for Clozapine Plasma Levels in Parkinson's Disease or Dementia: A Systematic Review and Individual Participant Data Meta-analysis. 帕金森病或痴呆患者氯氮平血浆水平的治疗参考范围：一项系统综述和个体参与者数据荟萃分析

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-04-17 DOI: 10.1055/a-2560-4028

Nazar Kuzo, Marianna Piras, Ulrich C Lutz, Ekkehard Haen, Chin B Eap, Christoph Hiemke, Michael Paulzen, Georgios Schoretsanitis

{"title":"Therapeutic Reference Range for Clozapine Plasma Levels in Parkinson's Disease or Dementia: A Systematic Review and Individual Participant Data Meta-analysis.","authors":"Nazar Kuzo, Marianna Piras, Ulrich C Lutz, Ekkehard Haen, Chin B Eap, Christoph Hiemke, Michael Paulzen, Georgios Schoretsanitis","doi":"10.1055/a-2560-4028","DOIUrl":"https://doi.org/10.1055/a-2560-4028","url":null,"abstract":"Clozapine is a recommended treatment for psychotic symptoms in patients with Parkinson's disease (PD) and/or dementia. However, the therapeutic reference range for clozapine in these patients has not been established hitherto.The study was performed in three university hospitals in Germany and Switzerland, including clozapine-treated patients with PD and/or dementia. The primary outcome was tolerability based on reports of adverse drug reactions and/or changes in laboratory tests or electrocardiogram and/or clozapine discontinuation. We meta-analyzed demographic and pharmacokinetic parameters in patients tolerating clozapine well versus not. A meta-analytic summary receiver operating characteristic (SROC) to establish the clozapine upper level associated with poor tolerability was estimated.We analyzed a total of 99 patients suffering from PD (56.6%) and/or dementia (49.5%) with a mean age of 70.3±9.5 years and 41.4% females; poor tolerability was reported in 26 of 99 patients (26.3%). When comparing patients with and without poor tolerability, there were no differences in age, body mass index, sex, smoking, or clozapine dose, nor did we find statistically significant differences in clozapine levels (standardized mean difference 0.46, 95% confidence interval - 0.04 to 0.96, p=0.07), and heterogeneity was low (I2=0.0%). Clozapine blood levels above 193 ng/mL were associated with poor tolerability (SROC area-under-curve 0.6, sensitivity 39.7%, specificity 79.9%).One of four patients with PD and/or dementia treated with clozapine did not tolerate clozapine well, which was associated with a trend toward elevated clozapine concentrations. Monitoring drug levels may help to improve tolerability in these patients.","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041990","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}

引用次数: 0

Therapeutic Potential of the Novel GLP-1 Receptor Agonist Semaglutide in Alcohol Use Disorder. 新型GLP-1受体激动剂Semaglutide治疗酒精使用障碍的潜力

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-04-14 DOI: 10.1055/a-2550-6470

Tingting Liu, Fuqiang Shi, Zhihua Guo, Hongwu Li, Di Qin

{"title":"Therapeutic Potential of the Novel GLP-1 Receptor Agonist Semaglutide in Alcohol Use Disorder.","authors":"Tingting Liu, Fuqiang Shi, Zhihua Guo, Hongwu Li, Di Qin","doi":"10.1055/a-2550-6470","DOIUrl":"https://doi.org/10.1055/a-2550-6470","url":null,"abstract":"Alcohol use disorder (AUD) is a prevalent neuropsychiatric disorder with serious health and social consequences. However, few licensed and successful pharmacotherapies exist for heterogeneous and complex disorders such as AUD, and these are poorly utilized. Preclinical and clinical findings suggest that the glucagon-like peptide-1 (GLP-1) system, a gut-brain peptide, is involved in the neurobiology of addictive behaviors. Additionally, the GLP-1 receptor (GLP-1R) has become a promising target for the treatment of AUD. Semaglutide, a novel GLP-1R agonist, has received clinical approval to treat type 2 diabetes in both subcutaneous and oral dosage forms. Studies have shown that it significantly reduces alcohol consumption and relapse of alcohol addiction in rats, suggesting its potential effectiveness for treating alcohol abuse in humans, particularly in overweight patients with AUDs. However, the use of semaglutide is associated with potential risks, such as gallbladder disease and clinical complications associated with delayed gastric emptying. This review evaluates the safety of semaglutide to inform its wider clinical application. Further extensive and in-depth studies on semaglutide are needed to reveal additional valuable clinical benefits.","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036395","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}

引用次数: 0

Strategies and Management for Psychiatric Drug Withdrawal: A Systematic Review of Case Reports and Series. 精神科药物戒断的策略和管理：病例报告和系列报告的系统回顾。

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-03-01 Epub Date: 2024-11-12 DOI: 10.1055/a-2443-1189

Jaqueline K Eserian, Vinícius P Blanco, Lucildes P Mercuri, Jivaldo R Matos, Eugênia A Kalleian, José C F Galduróz

{"title":"Strategies and Management for Psychiatric Drug Withdrawal: A Systematic Review of Case Reports and Series.","authors":"Jaqueline K Eserian, Vinícius P Blanco, Lucildes P Mercuri, Jivaldo R Matos, Eugênia A Kalleian, José C F Galduróz","doi":"10.1055/a-2443-1189","DOIUrl":"10.1055/a-2443-1189","url":null,"abstract":"In recent years, an increasing number of case reports on psychiatric drug withdrawal have emerged, offering detailed clinical insights and valuable real-world evidence on the withdrawal process. The objective of this review was to evaluate the strategies and management for withdrawing psychiatric drugs, as detailed in case reports and series. A systematic review of case reports and series published between 2013 and 2023 was conducted to capture the latest trends in psychiatric drug withdrawal. Cases were identified following the PRISMA guidelines by searching electronic databases Medline and Scopus. Finally, 47 case reports and series were included. The primary reason for drug withdrawal was attributed to the emergence of adverse events, followed by medication dependence or abuse, and clinical decision-making or symptom resolution. Gradual reduction of doses was implemented through various management approaches as the primary strategy for drug withdrawal, and drug substitution emerged as the second most employed strategy. Also, patients were mostly undergoing polypharmacy. Favorable treatment outcomes were reported in the majority of cases, suggesting that psychiatric drug withdrawal is feasible - though quite challenging in some situations. However, the remarkably low number of unsuccessful cases may create a misleading impression of the significant difficulty associated with withdrawing psychiatric drugs.","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"53-62"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625736","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}

引用次数: 0