Therapeutic Advances in Psychopharmacology最新文献

{"title":"Increased left dorsolateral prefrontal cortex density following escitalopram intake during relearning: a randomized, placebo-controlled trial in healthy humans.","authors":"Thomas Vanicek, Murray B Reed, René Seiger, Godber M Godbersen, Manfred Klöbl, Jakob Unterholzner, Benjamin Spurny-Dworak, Gregor Gryglewski, Patricia Handschuh, Clemens Schmidt, Christoph Kraus, Thomas Stimpfl, Rainer Rupprecht, Siegfried Kasper, Rupert Lanzenberger","doi":"10.1177/20451253221132085","DOIUrl":"10.1177/20451253221132085","url":null,"abstract":"<p><strong>Background: </strong>Serotonergic agents affect brain plasticity and reverse stress-induced dendritic atrophy in key fronto-limbic brain areas associated with learning and memory.</p><p><strong>Objectives: </strong>The aim of this study was to investigate effects of the antidepressant escitalopram on gray matter during relearning in healthy individuals to inform a model for depression and the neurobiological processes of recovery.</p><p><strong>Design: </strong>Randomized double blind placebo control, monocenter study.</p><p><strong>Methods: </strong>In all, 76 (44 females) healthy individuals performed daily an associative learning task with emotional or non-emotional content over a 3-week period. This was followed by a 3-week relearning period (randomly shuffled association within the content group) with concurrent daily selective serotonin reuptake inhibitor (i.e., 10 mg escitalopram) or placebo intake.</p><p><strong>Results: </strong>Via voxel-based morphometry and only in individuals that developed sufficient escitalopram blood levels over the 21-day relearing period, an increased density of the left dorsolateral prefrontal cortex was found. When investigating whether there was an interaction between relearning and drug intervention for all participants, regardless of escitalopram levels, no changes in gray matter were detected with either surfaced-based or voxel-based morphometry analyses.</p><p><strong>Conclusion: </strong>The left dorsolateral prefrontal cortex affects executive function and emotional processing, and is a critical mediator of symptoms and treatment outcomes of depression. In line, the findings suggest that escitalopram facilitates neuroplastic processes in this region if blood levels are sufficient. Contrary to our hypothesis, an effect of escitalopram on brain structure that is dependent of relearning content was not detected. However, this may have been a consequence of the intensity and duration of the interventions.</p><p><strong>Registration: </strong>ClinicalTrials.gov Identifier: NCT02753738; Trial Name: <i>Enhancement of learning associated neural plasticity by Selective Serotonin Reuptake Inhibitors</i>; URL: https://clinicaltrials.gov/ct2/show/NCT02753738.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"12 ","pages":"20451253221132085"},"PeriodicalIF":3.4,"publicationDate":"2022-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9677158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9163749","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":"Real-life effectiveness of transitioning from paliperidone palmitate 1-monthly to paliperidone palmitate 3-monthly long-acting injectable formulation.","authors":"Olivier Corbeil,&nbsp;Anne-Marie Essiambre,&nbsp;Laurent Béchard,&nbsp;Audrey-Anne Roy,&nbsp;Maxime Huot-Lavoie,&nbsp;Sébastien Brodeur,&nbsp;Ranjith Chandrasena,&nbsp;Chantale Thériault,&nbsp;Candice Crocker,&nbsp;Jean-Pierre Melun,&nbsp;Phil Tibbo,&nbsp;Marie-France Demers,&nbsp;Marc-André Roy","doi":"10.1177/20451253221136021","DOIUrl":"https://doi.org/10.1177/20451253221136021","url":null,"abstract":"<p><strong>Background: </strong>Non-adherence to antipsychotics in schizophrenia is associated with an increased risk of psychotic relapse and hospitalization, a risk that is reduced with the use of long-acting injectable (LAI) antipsychotics. Randomized clinical trials (RCTs) have demonstrated the efficacy of paliperidone palmitate 3-monthly (PP3M) for psychotic relapse prevention in schizophrenia, but it remains poorly documented among individuals treated in real-life settings who can benefit the most out of LAIs.</p><p><strong>Objectives: </strong>The objective of this study was to evaluate the effectiveness of PP3M in relapse prevention among patients with schizophrenia.</p><p><strong>Methods: </strong>This is a multicentre retrospective study conducted in four outpatients' clinics across Canada. All consecutive patients with a main diagnosis of schizophrenia who initiated PP3M between June 2016 and March 2020 were included. The primary outcome was psychotic relapse, defined using broad and clinically relevant criteria.</p><p><strong>Results: </strong>Among 178 consecutive patients who were switched to PP3M, the 12-month relapse rate was 18.5% and the relapse-free survival probability was 0.788 (95% confidence interval [CI] = 0.725-0.856). Comorbid diagnoses of personality disorders and substance use disorders were associated with hazard rates (HRs) of 3.6 (95% CI = 1.8-7.3, <i>p</i> < 0.001) and 3.1 (95% CI = 1.6-6.2), respectively. Increased psychopathology severity was associated with an increased likelihood of relapse, while having a job or being in school was protective.</p><p><strong>Conclusion: </strong>These findings reinforce the necessity of conducting research in patients with comorbid psychiatric disorders who are typically underrepresented in RCTs, yet overrepresented in real-life settings, in order to better inform and guide clinical practice.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":" ","pages":"20451253221136021"},"PeriodicalIF":4.2,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b5/17/10.1177_20451253221136021.PMC9666838.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40502467","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":"Acceptability of cannabidiol in patients with psychosis.","authors":"Edward Chesney, Doga Lamper, Millie Lloyd, Dominic Oliver, Emily Hird, Philip McGuire","doi":"10.1177/20451253221128445","DOIUrl":"10.1177/20451253221128445","url":null,"abstract":"<p><strong>Background: </strong>Cannabidiol (CBD) is a promising novel candidate treatment for psychosis. It has a more benign side effect profile than antipsychotic medications, and being treated with CBD is not perceived as being stigmatising. These observations suggest that patients with psychosis would find CBD to be a relatively acceptable treatment.</p><p><strong>Objective: </strong>This study tested the above hypothesis by assessing the views of a sample of patients.</p><p><strong>Methods: </strong>Patients with a psychotic disorder were invited to complete a survey exploring their expectations about the efficacy and side effects of CBD.</p><p><strong>Results: </strong>Seventy patients completed the survey. The majority (86%) were willing to try CBD as a treatment. Most patients believed that CBD would improve their psychotic symptoms (69%) and that it would have fewer side effects than their current medication (64%; mainly antipsychotics). A minority of patients (10%) were concerned that CBD might exacerbate their psychotic symptoms. This, however, appeared to reflect confusion between the effects of CBD and those of cannabis.</p><p><strong>Conclusion: </strong>Most patients with psychosis regard CBD as an acceptable treatment. Although CBD has not yet been approved as a treatment for psychosis, many patients are aware of it through the presence of CBD in cannabis and in health supplements. When added to the emerging evidence of its efficacy and the low risk of side effects, the high acceptability of CBD underlines its therapeutic potential.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"12 ","pages":"20451253221128445"},"PeriodicalIF":3.4,"publicationDate":"2022-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9608242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10566590","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":"Effect of long-acting injectable antipsychotics on hospitalizations and global functioning in schizophrenia: a naturalistic mirror-image study.","authors":"Cristiana Montemagni,&nbsp;Elisa Del Favero,&nbsp;Elena Cocuzza,&nbsp;Flavio Vischia,&nbsp;Paola Rocca","doi":"10.1177/20451253221122526","DOIUrl":"https://doi.org/10.1177/20451253221122526","url":null,"abstract":"<p><strong>Background: </strong>Partial adherence to antipsychotics is the most common cause of relapses and rehospitalization in patients with schizophrenia (SZ), leading to higher health care costs and psychosocial disability. The use of long-acting injectable (LAI) antipsychotics may improve therapeutic continuity and adherence to treatment.</p><p><strong>Objective: </strong>To assess the effectiveness of switching from oral antipsychotics (OAs) to long-acting antipsychotics.</p><p><strong>Methods: </strong>This 1-year mirror-image study evaluated the effect of switching from OAs to LAIs on the reduction of psychiatric hospitalizations and the improvement of global functioning in patients with schizophrenia. Differences in outcomes between second-generation (SGA) LAIs and first-generation (FGA) LAIs were also analyzed.</p><p><strong>Results: </strong>In all, 166 patients were included: 32.5% treated by FGA-LAIs and 67.5% by SGA-LAIs. There was an overall reduction of 71% in the average number of hospital admissions and an overall improvement of 29.3% in the Global Assessment of Functioning (GAF) score between the previous 12 months and the 12 months following the switching to LAIs. Patients who switched to SGA-LAIs had no significant differences in hospitalization occurrences but a significant improvement in GAF scores when compared with patients who switched to FGA-LAIs.</p><p><strong>Conclusion: </strong>Our results suggest that using LAIs could be the most adequate treatment choice for SZ patients with a high risk of relapse and low adherence rate. Patients with poorer social functioning may be ideal candidates for SGA-LAIs treatment. Our findings may be of particular interest from a clinical and health care management perspective.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":" ","pages":"20451253221122526"},"PeriodicalIF":4.2,"publicationDate":"2022-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/82/f4/10.1177_20451253221122526.PMC9549097.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33503149","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 outcome analysis of patients with autism spectrum disorder: analysis from the UK Medical Cannabis Registry.","authors":"Simon Erridge,&nbsp;Jess Kerr-Gaffney,&nbsp;Carl Holvey,&nbsp;Ross Coomber,&nbsp;Daniela A Riano Barros,&nbsp;Urmila Bhoskar,&nbsp;Gracia Mwimba,&nbsp;Kavita Praveen,&nbsp;Chris Symeon,&nbsp;Simmi Sachdeva-Mohan,&nbsp;Mikael H Sodergren,&nbsp;James J Rucker","doi":"10.1177/20451253221116240","DOIUrl":"https://doi.org/10.1177/20451253221116240","url":null,"abstract":"<p><strong>Introduction: </strong>Cannabis-based medicinal products (CBMPs) have been identified as a promising novel therapeutic for symptoms and comorbidities related to autism spectrum disorder (ASD). However, there is a paucity of clinical evidence of their efficacy and safety. Objective: This case series aims to assess changes to health-related quality of life and the incidence of adverse events in patients treated with CBMPs for associated symptoms of ASD enrolled on the UK Medical Cannabis Registry (UKMCR).</p><p><strong>Methods: </strong>Patients treated with CBMPs for ASD-related symptoms for a minimum of 1 month were identified from the UKMCR. Primary outcomes were changes in validated patient-reported outcome measures [Generalised Anxiety Disorder-7 (GAD-7), Single-Item Sleep Quality Scale (SQS), 5-level version of the EQ-5D (EQ-5D-5L) index values] at 1, 3 and 6 months compared with baseline. Adverse events were recorded and analysed. Statistical significance was determined by <i>p</i> < 0.050.</p><p><strong>Results: </strong>Seventy-four patients with ASD were included in the analysis. The mean age of participants was 32.7 (±11.6) years. There were significant improvements in general health-related quality of life and sleep as assessed by the EQ-5D-5L, SQS and GAD-7 at 1 and 3 months, with sustained changes in EQ-5D-5L and SQS at 6 months (<i>p</i> < 0.010). There were 180 (243.2%) adverse events reported by 14 (18.9%) participants. If present, adverse events were commonly mild (<i>n</i> = 58; 78.4%) or moderate (<i>n</i> = 81; 109.5%), rather than severe (<i>n</i> = 41; 55.4%).</p><p><strong>Conclusion: </strong>This study demonstrated an associated improvement in general health-related quality of life, and anxiety- and sleep-specific symptoms following initiation of treatment with CBMPs in patients with ASD. These findings, while promising, are limited by the confines of the study which lacks a control arm and is subject to attrition bias. Therefore, further evaluation is required with randomised controlled trials.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":" ","pages":"20451253221116240"},"PeriodicalIF":4.2,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9500308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33484763","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":"Risperidone-induced priapism: a case report and literature review.","authors":"Sarra Ateb,&nbsp;Taoufik Fourati,&nbsp;Hammadi Ben Rejeb,&nbsp;Dominique Januel,&nbsp;Noomane Bouaziz","doi":"10.1177/20451253221113246","DOIUrl":"https://doi.org/10.1177/20451253221113246","url":null,"abstract":"<p><p>Priapism is a rare pathological condition defined as painful and persistent penile erection that is unrelated to sexual stimulation. It can be classified as ischaemic or non-ischaemic. Many causes have been attributed to ischaemic priapism, including the use of some medications such as antipsychotics. The mechanism of priapism associated with antipsychotics is thought to be related to alpha-adrenergic blockage that is mediated by the alpha receptors in the corpora cavernosa of the penis. In this paper, we describe a case of a patient who suffered from Risperidone-induced priapism, and how this adverse effect was resolved by switching to olanzapine followed by olanzapine pamoate. A literature search on PubMed/Medline up to 2011 was conducted by some doctors from London and found 30 cases of priapism associated with risperidone. Based on this work, we searched PubMed through 2021, using the keywords 'priapism' and 'risperidone' and found a total of 43 cases of priapism involving risperidone. Priapism is not correlated with the dosage of this psychotropic drug, and has also occasionally occurred when risperidone has been used in conjunction with another drug. The question of choosing a replacement antipsychotic after the first one has induced priapism, remains problematic. It would be preferable to switch to a drug with less marked alpha1-blocking properties, but no consensus has been reached as to the best choice of medication. Finally, any prescription of an antipsychotic treatment must be preceded by a careful interrogation in search of risk factors for priapism, and the patient should be made aware of the possible occurrence of this side effect and the need to then seek urgent medical advice.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":" ","pages":"20451253221113246"},"PeriodicalIF":4.2,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/37/10.1177_20451253221113246.PMC9424871.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40344056","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":"Antipsychotic polypharmacy and clozapine prescribing patterns: evolution and correlates before and after a psychiatric hospitalisation.","authors":"Juliette Lagreula,&nbsp;Philippe de Timary,&nbsp;Laure Elens,&nbsp;Olivia Dalleur","doi":"10.1177/20451253221112587","DOIUrl":"https://doi.org/10.1177/20451253221112587","url":null,"abstract":"<p><strong>Background: </strong>Antipsychotic polypharmacy (APP) prescribing and clozapine underuse are considered inappropriate prescribing in schizophrenia. Psychiatric hospitalisations may be suitable occasions to re-evaluate patient pharmacotherapy and to switch to monotherapy.</p><p><strong>Objectives: </strong>To explore the evolution of APP and other psychotropic prescribing patterns during psychiatric hospitalisations, to detect characteristics associated with APP on admission and at discharge, and to examine clozapine prescribing patterns.</p><p><strong>Design: </strong>We performed a retrospective observational study based on electronic health records.</p><p><strong>Methods: </strong>Data on adult inpatients diagnosed with schizophrenia spectrum disorders were collected retrospectively from 6 Belgian hospitals in 2020-2021.</p><p><strong>Results: </strong>Of the 516 patients included, APP prescribing increased significantly from 47.9% on hospital admission to 59.1% at discharge. On admission and at discharge, APP was associated with prior clozapine use (OR_admission = 2.53, CI = 1.1-5.84, OR_discharge = 11.01, CI = 4.45-27.28), treatment with a first-generation antipsychotic (OR_admission = 26.79, CI = 13.08-54.86, OR_discharge = 25.2, CI = 12.2-52.04), increased antipsychotic exposure (OR_admission = 8.93, CI = 5.13-15.56, OR_discharge = 19.89, CI = 10-39.54), and a greater number of hypno-sedatives (OR_admission = 1.88, CI = 1.23-2.88, OR_discharge = 4.18, CI = 2.53-6.91). APP was negatively associated with involuntary admission (OR_admission = 0.31, CI = 0.14-0.7, OR_discharge = 0.3, CI = 0.13-0.68). When using an alternative definition of monotherapy (i.e. including patients with an add-on low-dose antipsychotic for sleep disorders), alcohol use disorder (OR_admission = 0.26, CI = 0.13-0.54) and higher age (OR_discharge = 0.53, CI = 0.29-0.95) were negatively associated with APP, and living in a residential facility (OR_discharge = 2.39 CI = 1.21-4.71) and a higher daily dosage of benzodiazepines during the stay (OR_discharge = 1.32 CI = 1.03-1.69) increased the odds of being discharged on APP. On admission, 9.3% of patients were being treated with clozapine. Although 28.1% of patients were eligible for clozapine treatment, only 11% of patients were discharged with a clozapine prescription. For 7 of the 10 patients with a new clozapine prescription, it was directly prescribed in combination with another antipsychotic, without a prior trial of clozapine monotherapy.</p><p><strong>Conclusion: </strong>Suboptimal prescriptions of antipsychotics in patients with schizophrenia persist after psychiatric hospitalisations and are associated with identifiable characteristics.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":" ","pages":"20451253221112587"},"PeriodicalIF":4.2,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/07/0d/10.1177_20451253221112587.PMC9425880.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40344055","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":"Who is prescribed valproate and how carefully is this treatment reviewed in UK mental health services? Data from a clinical audit.","authors":"Carol Paton,&nbsp;Leslie Citrome,&nbsp;Emilio Fernandez-Egea,&nbsp;Olivia Rendora,&nbsp;Thomas R E Barnes","doi":"10.1177/20451253221110016","DOIUrl":"https://doi.org/10.1177/20451253221110016","url":null,"abstract":"<p><strong>Background: </strong>The licensed indications for valproate are narrow, yet this medication is commonly prescribed in mental health services.</p><p><strong>Objectives: </strong>To explore the target symptoms/behaviours for which valproate is prescribed and how well the efficacy and tolerability of this treatment are monitored in routine clinical practice.</p><p><strong>Design: </strong>An audit-based quality improvement (QI) programme in UK mental health services.</p><p><strong>Methods: </strong>Information on valproate prescribing was collected from clinical records using a bespoke data collection tool.</p><p><strong>Results: </strong>Sixty-four NHS mental health Trusts/healthcare organisations submitted data on valproate treatment for 5320 patients. Valproate was clearly prescribed for a licensed indication in 1995 (38%) patients, off-label in 1987 (37%) while the indication was uncertain/not available in 1338 (25%). Of the 919 patients started on valproate treatment within the past year, between a half and two-thirds had each of the relevant baseline physical health checks documented. In 539 (59%) of these patients, valproate was prescribed for an unlicensed indication; the prescription was recognised as off-label in 363 (67%), 20 (6%) of whom were documented as having had this explained to them. Of 631 patients prescribed valproate for between 3 months and a year, early on-treatment assessments of response and side effects were documented in 441 (70%) and 332 (53%), respectively. Of 4401 patients treated for more than a year, annual on-treatment reviews of clinical response and side effects were documented in 2771 (63%) and 2140 (49%), respectively.</p><p><strong>Conclusion: </strong>Our data suggest the majority of prescriptions for valproate in mental health services are not for a licensed indication. Furthermore, patients rarely receive an explanation that their valproate prescription is off-label, perhaps partly because the licensed indications are not widely understood by prescribers. Given the very limited evidence for efficacy for the off-label uses of valproate, failure to routinely conduct early on-treatment and annual reviews of the benefits and side effects of this medication may result in patients remaining on ineffective and poorly tolerated treatment by default.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":" ","pages":"20451253221110016"},"PeriodicalIF":4.2,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9d/b5/10.1177_20451253221110016.PMC9425878.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40344057","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":"Plasma levels of interleukin-6 and 3-methoxy-4-hydroxyphenylglycol and treatment with milnacipran in major depression.","authors":"Reiji Yoshimura,&nbsp;Naomichi Okamoto,&nbsp;Atsuko Ikenouchi","doi":"10.1177/20451253221116238","DOIUrl":"https://doi.org/10.1177/20451253221116238","url":null,"abstract":"Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). TherapeuTic advances in psychopharmacology","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":" ","pages":"20451253221116238"},"PeriodicalIF":4.2,"publicationDate":"2022-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7a/dd/10.1177_20451253221116238.PMC9364219.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40708755","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":"Dose-response analysis of aripiprazole in patients with schizophrenia in Taiwan.","authors":"Yun Tien,&nbsp;Hsiang-Ping Huang,&nbsp;Ding-Lieh Liao,&nbsp;Shang-Chien Huang","doi":"10.1177/20451253221113238","DOIUrl":"https://doi.org/10.1177/20451253221113238","url":null,"abstract":"<p><strong>Background: </strong>Aripiprazole is a third-generation antipsychotic agent with acceptable efficacy and a good safety profile. Previous studies have indicated the therapeutic serum concentration of aripiprazole to be 100 to 350 ng/ml; however, most of these studies examined a Western population. Patients with schizophrenia from Tungs' Taichung MetroHarbor Hospital in central Taiwan were recruited to analyze the dose-response relationship of aripiprazole in the Chinese population.</p><p><strong>Objective: </strong>We aimed to investigate whether a serum concentration of aripiprazole higher than the current suggested range leads to higher response rates.</p><p><strong>Design: </strong>A prospective cohort study was designed to investigate the response rates in different studied cohorts grouped by serum concentration of aripiprazole.</p><p><strong>Data sources and methods: </strong>Data of 64 patients who presented to a single medical center in central Taiwan and who received therapeutic drug monitoring (TDM) were obtained. Serum concentrations of aripiprazole were correlated with the clinical response of patients by using the Clinical Global Impressions (CGI) scores.</p><p><strong>Results: </strong>The mean concentration of aripiprazole was 432.1 ± 275.1 ng/ml in the study cohort. Among the much-improved patients, the mean serum concentration of aripiprazole was 494 ± 273 ng/ml (25th-75th percentiles 264-666 ng/ml), which was higher than the current recommended therapeutic target of 100-350 ng/ml for aripiprazole. The response rate in the severe group (baseline CGI score of 6 or 7) was significantly higher than in the moderate group (baseline CGI score of 4 or 5; 86.7% <i>versus</i> 55.9%, <i>p</i> = 0.007).</p><p><strong>Conclusion: </strong>A significantly higher response rate was observed in the study cohort with serum aripiprazole concentrations over 300 ng/ml. Therefore, dosing higher than the current recommended range may potentially improve the treatment efficacy in the Chinese population. Because the serum concentration varies among patients due to multiple intrinsic and extrinsic factors, TDM, especially in outpatients, is recommended if the clinical response is limited.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":" ","pages":"20451253221113238"},"PeriodicalIF":4.2,"publicationDate":"2022-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2b/52/10.1177_20451253221113238.PMC9340887.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40667676","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}