Therapeutic Advances in Psychopharmacology最新文献

{"title":"Intranasal esketamine in treatment-resistant depression: long-term dosing patterns and clinical outcomes in a 5-year observational study.","authors":"Alessandro Cuomo, Roger McIntyre, Despoina Koukouna, Mario Pinzi, Simone Pardossi, Bernardo Firenzuoli, Giovanni Barillà, Pietro Carmellini, Alberto Alamia, Andrea Fagiolini","doi":"10.1177/20451253261437597","DOIUrl":"https://doi.org/10.1177/20451253261437597","url":null,"abstract":"<p><strong>Background: </strong>Treatment-resistant depression (TRD) remains a major clinical challenge, and long-term real-world data on intranasal esketamine are limited.</p><p><strong>Objectives: </strong>To describe long-term dosing patterns and clinical outcomes associated with intranasal esketamine in routine clinical practice.</p><p><strong>Design: </strong>Single-center observational cohort study with descriptive analyses.</p><p><strong>Methods: </strong>We analyzed 45 patients with TRD treated with intranasal esketamine in a naturalistic setting, with follow-up extending up to 260 weeks. Esketamine was used adjunctively with ongoing oral antidepressants. Outcomes included the Montgomery-Åsberg Depression Rating Scale (MADRS), the Young Mania Rating Scale (YMRS), and the Glasgow Antipsychotic Side-effect Scale (GASS). Treatment patterns were summarized using person-time (person-weeks).</p><p><strong>Results: </strong>Baseline MADRS was 40.0 (SD 4.63). Mean MADRS decreased to 22.9 (SD 7.99) at week 4 and to 9.70 (SD 5.35) at week 52, with mean scores remaining around 9-10 at later time points among patients with available follow-up. Eight patients (17.8%) discontinued treatment (lack of efficacy <i>n</i> = 4; intolerable adverse effects <i>n</i> = 3; lost to follow-up <i>n</i> = 1). No treatment-emergent hypomania or manic symptoms were observed; YMRS scores decreased over time. GASS scores were low overall, with median values of 0 from week 13 onwards.</p><p><strong>Conclusion: </strong>In a real-world TRD cohort with complex comorbidities, intranasal esketamine used adjunctively was associated with sustained symptom improvement and a favorable long-term safety profile among patients who continued treatment, with dosing evolving from induction to individualized maintenance schedules. Findings are limited by the observational design, concomitant treatments, and survivor bias.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"16 ","pages":"20451253261437597"},"PeriodicalIF":4.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781891","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":"Adult psychiatrists' views on clozapine prescribing for schizophrenia in Germany-an online survey.","authors":"Mishal Qubad, Ida Marie Ehret, Christian J Bachmann, Robert A Bittner","doi":"10.1177/20451253261434380","DOIUrl":"https://doi.org/10.1177/20451253261434380","url":null,"abstract":"<p><strong>Background: </strong>Clozapine remains the only effective antipsychotic drug for treatment-resistant schizophrenia (TRS), yet it continues to be markedly underused in most industrialized countries including Germany. Previous studies have identified prescriber-related factors such as concerns about adverse drug reactions, the burden of mandatory monitoring, and limited experience with clozapine use and TRS recognition as major contributors to this persistent underutilization. However, these issues have not been studied for the German healthcare system.</p><p><strong>Objectives: </strong>To investigate prescriber attitudes toward clozapine use for schizophrenia in Germany and identify related treatment barriers.</p><p><strong>Design: </strong>Cross-sectional, web-based survey study.</p><p><strong>Methods: </strong>We conducted a web-based cross-sectional survey using PsyToolkit. Our questionnaire assessed clinicians' demographics, familiarity with relevant national guidelines, practical experience with clozapine and formalized training in its use, perceived treatment barriers, and presumptions about patients' attitudes toward clozapine. Data were predominantly analyzed descriptively.</p><p><strong>Results: </strong>A total of 155 psychiatrists-most of them board-certified and nearly all regular clozapine prescribers for schizophrenia-completed the survey. Most participants were familiar with guideline recommendations for clozapine initiation. However, even among them, most preferred to attempt at least one trial of antipsychotic polypharmacy before starting clozapine. Formalized training had a positive impact on knowledge regarding clozapine's effectiveness in reducing negative symptoms, aggressive behavior, and suicidality. While most participants acknowledged clozapine's effectiveness in reducing all-cause mortality, only a small proportion of participants acknowledged its effectiveness in reducing cardiovascular mortality. Notably, three quarters of participants presumed that patients would prefer standard antipsychotics over clozapine. Monitoring requirements and concerns regarding weight gain and blood dyscrasia were ranked as the main barriers impeding clozapine use.</p><p><strong>Conclusion: </strong>We identified several modifiable prescriber-related factors limiting clozapine use for schizophrenia in Germany. Implementing mandatory targeted training programs during residency and regular use of shared decision-making to emphasize the patients' perspective might facilitate a timelier and widespread use of clozapine.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"16 ","pages":"20451253261434380"},"PeriodicalIF":4.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781862","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":"Clozapine-related neutropenia and agranulocytosis in Korea: 2025 update for rethinking the role of monitoring system.","authors":"Nuree Kang, Ji Seon Jang, Sung Woo Joo, Jeong Hoon Lee, Jae Hoon Jeong, Minah Kim, Yong Min Ahn, Jun Soo Kwon, Yong Sik Kim, Jung Sun Lee, Se Hyun Kim","doi":"10.1177/20451253261440341","DOIUrl":"https://doi.org/10.1177/20451253261440341","url":null,"abstract":"<p><strong>Background: </strong>In February 2025, the FDA ended the mandatory Risk Evaluation and Mitigation Strategy requirements for clozapine. Korea continues mandatory hematologic testing under the Clozapine Patient Monitoring System (CPMS), yet no nationwide updates have been reported since 2006.</p><p><strong>Objectives: </strong>This study aimed to provide contemporary real-world evidence on the incidence, timing, and clinical outcomes of clozapine-associated neutropenia and agranulocytosis in Korea, and to evaluate adherence to monitoring regulations, to inform potential revision of the national CPMS.</p><p><strong>Design: </strong>A retrospective, multicenter cohort study was conducted using anonymized electronic medical records from two Korean tertiary hospitals between 2000 and 2023.</p><p><strong>Methods: </strong>Patients with schizophrenia spectrum disorders who had newly initiated clozapine were included. Absolute neutrophil count (ANC) data were used to identify neutropenia (ANC < 1500/μL), moderate neutropenia (<1000/μL), and agranulocytosis (<500/μL). Chart review determined causality for agranulocytosis. Monitoring adherence was assessed based on the proportion of ANC tests conducted within recommended intervals.</p><p><strong>Results: </strong>Among 2417 newly initiated patients (from 3364 total users), neutropenia occurred in 9.7%. Of these, 47.4% occurred within 18 weeks, and none who continued treatment progressed to agranulocytosis. Patients with neutropenia had lower baseline ANC than those without. Moderate neutropenia occurred in 1.7% and showed similar clinical patterns, most events being transient. Ten cases of agranulocytosis were identified, of which four (0.17%) were clozapine-related. All appeared abruptly within 5 weeks of initiation without preceding neutropenia or low baseline ANC, and recovered after discontinuation. Monitoring adherence was suboptimal: during the first 18 weeks, adherence to ⩽10-day interval was 73.7%, while 8.7% patients had no ANC tests; adherence after 1 year fell below 50%.</p><p><strong>Conclusion: </strong>Neutropenia is relatively common but usually low-risk, whereas clozapine-induced agranulocytosis is rare, abrupt, and confined to the early period. These findings suggest reconsideration of current hematological monitoring regulations regarding clozapine.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"16 ","pages":"20451253261440341"},"PeriodicalIF":4.0,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699780","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":"Clinical predictors of stimulant efficacy in adults with ADHD.","authors":"Maura DiSalvo, Joseph Biederman, Hannah O'Connor, Maria Iorini, Allison Green, K Yvonne Woodworth, Janet Wozniak, Gagan Joshi, John Gabrieli, Mai Uchida","doi":"10.1177/20451253261428807","DOIUrl":"https://doi.org/10.1177/20451253261428807","url":null,"abstract":"<p><strong>Background: </strong>Attention-deficit/hyperactivity disorder (ADHD) is a disorder marked by inattentiveness and/or hyperactivity and increased impulsivity. A common treatment for ADHD is stimulant medications, with a formulation of methylphenidate or amphetamine. Although stimulant medication is effective in most patients, 40% show no response. There have been attempts to predict stimulant efficacy through neuroimaging and electroencephalograms; however, these methods are expensive and not sustainable in day-to-day clinical practices.</p><p><strong>Objectives: </strong>This study aimed to identify clinical factors that could be used to predict which patients would best respond to stimulants.</p><p><strong>Design: </strong>The reporting of this study conforms to the STROBE statement. This was a naturalistic prospective observational study.</p><p><strong>Methods: </strong>Thirty-six medication-naïve adults with ADHD were prescribed stimulant medication and naturalistically followed for an average of 116 days. Demographics, type of stimulant, and seven clinical rating scales were analyzed to identify response predictors. Truncated Poisson regressions, stepwise logistic regressions, receiver operating characteristic curve analysis, and Bonferroni corrections were performed.</p><p><strong>Results: </strong>Executive function impairment and better quality of life were found to be the best indicators for stimulant response. Higher scores on Adult Self-Report (ASR) Thought Problems, Withdrawn Problems, Internalizing Problems, and Intrusive Thoughts were indicative of lower stimulant efficacy. Poorer working memory and task monitoring also predicted lower stimulant response.</p><p><strong>Conclusion: </strong>These clinical measures could aid clinicians and patients in predicting who would better respond to stimulant medications and reduce the time that patients wait before finding an effective treatment. Executive functioning, quality of life, and ASR profile measurements can be used to best manage ADHD symptomology.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"16 ","pages":"20451253261428807"},"PeriodicalIF":4.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634311","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":"MicroRNAs in metabolic effects with atypical antipsychotics-a scoping review.","authors":"Weng Tong Wu, Deonna Setiawan, Stephen J Glatt, Jen-Tsan Chi, Ping-I Lin","doi":"10.1177/20451253261430603","DOIUrl":"https://doi.org/10.1177/20451253261430603","url":null,"abstract":"<p><strong>Background: </strong>Metabolic side effects associated with atypical antipsychotics represent a major challenge in the clinical management of schizophrenia, contributing to poor treatment adherence and an increased risk of relapse. MicroRNAs (miRNAs) have emerged as promising diagnostic biomarkers for schizophrenia, with growing evidence indicating that their expression is modulated by antipsychotic treatment. Dysregulated miRNAs may not only reflect underlying disease mechanisms but also actively contribute to therapeutic response and the development of metabolic side effects.</p><p><strong>Objectives: </strong>This scoping review critically evaluates the current literature on miRNAs in schizophrenia, focusing on their role in modulating treatment response and antipsychotic-induced metabolic disturbances. Key knowledge gaps are identified to inform future translational research.</p><p><strong>Eligibility criteria: </strong>We included studies involving adults or animal models with psychotic symptoms (with schizophrenia as the primary diagnosis) treated with atypical antipsychotics. Eligible studies reported associations between miRNA expression, metabolic parameters, and clinical outcomes.</p><p><strong>Sources of evidence: </strong>A rapid review was conducted using PubMed to identify relevant articles published up to December 1, 2025 and 16 articles were included for final review.</p><p><strong>Charting methods: </strong>Data charting was performed by one reviewer using a pre-developed and piloted form. The review was reported according to the Preferred Reporting items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR checklist).</p><p><strong>Results: </strong>Atypical antipsychotics, particularly those acting on dopamine and serotonin receptors, were shown to modulate specific dysregulated miRNAs. Several of these miRNAs regulate genes involved in metabolic pathways, such as lipid and glucose metabolism, potentially contributing to the variability in cardiometabolic side effects observed across individuals.</p><p><strong>Conclusion: </strong>Emerging evidence suggests that miRNAs may play a dual role in mediating both therapeutic efficacy and metabolic risk in schizophrenia treatment. However, the underlying mechanisms remain incompletely understood. Robust, large-scale studies are urgently needed to validate miRNAs as clinically actionable biomarkers for guiding personalized antipsychotic therapy.</p><p><strong>Trial registration: </strong>A protocol was not prospectively registered, as the aim of this scoping review was exploratory in nature.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"16 ","pages":"20451253261430603"},"PeriodicalIF":4.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13039609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147609833","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":"Effects of cariprazine on cholesterol, glucose, and weight in patients with schizophrenia: a systematic review and meta-analysis.","authors":"Isabella Berardelli, Mariarosaria Cifrodelli, Attilio Valerio Mammoliti, Federico Formica, Riccardo Iannazzo, Roger S McIntyre, Maurizio Pompili","doi":"10.1177/20451253251408651","DOIUrl":"10.1177/20451253251408651","url":null,"abstract":"<p><strong>Background: </strong>Cariprazine is a second-generation antipsychotic approved for treating schizophrenia, acute manic or mixed episodes associated with bipolar I disorder, and major depressive disorder. Antipsychotic treatment is often associated with metabolic alterations, including weight gain, dyslipidemia, and increased risk of type 2 diabetes and cardiovascular disease.</p><p><strong>Objectives: </strong>We performed a systematic review and meta-analysis with the overarching aim of synthesizing study results that describe the effect of cariprazine on glucose and lipid homeostasis, as well as weight, in persons living with schizophrenia.</p><p><strong>Design: </strong>A systematic literature review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</p><p><strong>Data sources and methods: </strong>We systematically searched three major electronic databases of medical and social science research papers (PubMed/MEDLINE, PsycINFO, and Cochrane Central Register of Controlled Trials (CENTRAL) for relevant titles and abstracts published between January 2014 and March 2025.</p><p><strong>Results: </strong>Using the Covidence platform, we included 12 studies for the systematic review and four randomized controlled studies for the meta-analysis. Meta-analysis revealed a significant difference in weight change between cariprazine and placebo; however, no significant differences were observed for total cholesterol or fasting glucose.</p><p><strong>Conclusion: </strong>This meta-analysis suggests that cariprazine, although associated with modest weight gain, does not cause significant alterations in lipid and glycemic profiles, confirming its favorable metabolic profile compared to other atypical antipsychotics.</p><p><strong>Trial registration: </strong>This study is registered with the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY), 2025100014.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"16 ","pages":"20451253251408651"},"PeriodicalIF":4.0,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594965","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":"A scoping review of mystical-type experiences and mood symptom outcomes in psychedelic therapy clinical trials: comparing life-threatening disease and depressive populations.","authors":"Ana Deutsch, Luis E Contreras, Sarah Kratina, Leah M Mayo","doi":"10.1177/20451253261433836","DOIUrl":"10.1177/20451253261433836","url":null,"abstract":"<p><strong>Background: </strong>Psychedelic therapies are gaining attention as tools to alleviate anxiety and depression across various clinical populations. However, the mechanisms behind psychedelics' therapeutic efficacy and the potential differences in how patients with certain diagnoses experience their subjective effects remain unknown. One commonly suggested mediator of positive outcomes across psychedelics trials is the occurrence of mystical-type experiences.</p><p><strong>Objectives: </strong>This scoping review examines the relationship between psychedelic-induced mystical-type experiences and changes in anxiety and depression symptoms, comparing findings across populations with a life-threatening disease (LTD) and other psychiatric populations. Given the unique challenges faced by patients with an LTD diagnosis, this review aimed to determine whether there are any distinct patterns differentiating the effects of mystical-type experiences and mood outcomes in this population from other psychiatric populations.</p><p><strong>Charting methods: </strong>Following a scoping review method, PubMed, Embase, and PsycINFO were reviewed.</p><p><strong>Eligibility criteria: </strong>Clinical trials administering psychedelics to adults and measuring mystical-type experiences and their relationship to anxiety and/or depression outcomes were included.</p><p><strong>Sources of evidence: </strong>Thirteen clinical trials (<i>n</i> = 410 participants) met the inclusion criteria. Five studies administered psychedelic therapy to LTD populations, eight trials administered psychedelic therapy to patients with depression.</p><p><strong>Results: </strong>Across all studies, 69% of trials reported a positive relationship between mystical-type experiences and improvement in anxiety and/or depression outcomes. This relationship was found in 80% of LTD studies and 63% of studies in depressive populations.</p><p><strong>Conclusion: </strong>Mystical-type experiences were commonly associated with reductions in anxiety and/or depression symptoms following psychedelic therapy in both LTD and depressive populations. However, this relationship may depend on multiple factors, including the timing of symptom assessments and therapeutic context. Future studies should examine the variables that affect mystical-type experiences, along with other aspects of set and setting, to determine how to best facilitate positive outcomes induced by psychedelics.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"16 ","pages":"20451253261433836"},"PeriodicalIF":4.0,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594894","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":"Adjunctive xanomeline/trospium in clozapine-resistant schizophrenia: two case reports demonstrating limited response.","authors":"Vanessa M Dang, John M Powers, Matej Markota, Jonathan G Leung","doi":"10.1177/20451253261433832","DOIUrl":"10.1177/20451253261433832","url":null,"abstract":"<p><p>Few pharmacologic options exist for patients with clozapine-resistant schizophrenia (CRS) or schizoaffective disorder. Xanomeline/trospium represents a new class of antipsychotic medication that has efficacy as monotherapy for schizophrenia. Despite distinct mechanistic differences from standard antipsychotics, phase III evidence suggest limited benefit of xanomeline/trospium in the augmentation of non-clozapine antipsychotics. Research on the use of xanomeline/trospium in patients with clozapine-resistant illness or with partial response to clozapine is even more limited. Two cases of this combination are described with a discussion on key considerations for the management of CRS. The first case is a 42-year-old patient whose clozapine dose was limited by supratherapeutic clozapine levels in response to minor infections. She was ultimately stabilized on a combination of clozapine and xanomeline/trospium, with yet further improvements from electroconvulsive therapy (ECT). The second case is a 31-year-old patient who elected to discontinue clozapine and ECT due to cognitive side effects, despite improvement in psychosis. The addition of xanomeline/trospium to clozapine caused sialorrhea and did not produce observable clinical benefits and was thus discontinued. These case reports describe clozapine-resistant patients who were trialed on xanomeline/trospium combined with clozapine and still required consideration of ECT for symptom control. Overall, future investigation into xanomeline/trospium effectiveness as an augmentation agent or as monotherapy for CRS is necessary to guide clinical decision-making.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"16 ","pages":"20451253261433832"},"PeriodicalIF":4.0,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13031730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575462","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":"Clinical hallmarks and peripheral immune factors associated with antipsychotic-induced constipation in schizophrenia.","authors":"Miaomiao Shao, Tingting Zhu, Xiuxiu Hu, Xinyu Fang, Xinming Pan, Lu Wen, Peng Dai, Nousayhah Amdanee, Lin Zhang, Yue Xu, Xiangrong Zhang","doi":"10.1177/20451253261432764","DOIUrl":"10.1177/20451253261432764","url":null,"abstract":"<p><strong>Background: </strong>Constipation is a frequent adverse effect of antipsychotic treatment in schizophrenia.</p><p><strong>Objectives: </strong>This study aimed to investigate the prevalence and risk factors of antipsychotic-induced constipation (AIC) in patients with schizophrenia and examine associated alterations in peripheral immune factors.</p><p><strong>Methods: </strong>A total of 154 patients with schizophrenia were categorized into constipation and non-constipation groups based on the Rome IV constipation criteria. Clinical assessment included the Positive and Negative Syndrome Scale, Constipation Assessment Scale, and Bristol Stool Classification Scale. A subset of patients underwent secondary confirmation of constipation status using the Radiopaque Marker. Peripheral immune factors were analyzed using ProcartaPlex in 44 patients with constipation and 44 without.</p><p><strong>Design: </strong>This was a two-phase, cross-sectional observational study.</p><p><strong>Results: </strong>The prevalence of constipation was 36.36% (56/154). Among the 88 patients assessed for immune factors, serum IL-10 levels were nominally elevated in the constipation group compared to the non-constipation group (<i>p</i> = 0.043, Cohen's <i>d</i> = 0.32), an associated that did not remian statistically significant after false discovery rate correction (FDR-adjusted <i>p</i> = 0.432). In addition, the equivalent dose of clozapine showed a negative correlation with IL-1β levels. Logistic regression analysis showed a preliminary association of IL-10 with constipation.</p><p><strong>Conclusion: </strong>The relatively high prevalence of AIC, particularly among clozapine users, highlights the need for increased clinical awareness and monitoring. The findings may suggest a possible link between AIC and inflammatory processes. Notably, a preliminary observation of elevated peripheral IL-10 levels in patients with constipation needs.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"16 ","pages":"20451253261432764"},"PeriodicalIF":4.0,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13031729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575453","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":"A rapid clinical response to etifoxine in treatment-resistant obsessive-compulsive disorder: a case report of a patient with comorbid bipolar disorder.","authors":"Pornjira Pariwatcharakul, Punyisa Prachgosin","doi":"10.1177/20451253261429968","DOIUrl":"10.1177/20451253261429968","url":null,"abstract":"<p><p>This case report describes the rapid clinical response to etifoxine, an oral translocator protein 18 kDa (TSPO) ligand, in a patient with severe, treatment-resistant obsessive-compulsive disorder (OCD) with comorbid bipolar I disorder. Despite extensive prior pharmacological treatments and neurosurgical interventions, the patient experienced significant symptom amelioration within days of etifoxine initiation (the Yale-Brown Obsessive-Compulsive Scale (YBOCS) score decreased from 50 to 29). We discussed the potential mechanisms underlying this rapid response, including direct γ-aminobutyric acid (GABA) receptor modulation, increased endogenous neurosteroidogenesis, reduced neuroinflammation, and modulation of the gut-brain axis. This case highlights etifoxine as a novel therapeutic option for treatment-resistant OCD and underscores the need for further research into TSPO ligands in this context.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"16 ","pages":"20451253261429968"},"PeriodicalIF":4.0,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514867","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}