Therapeutic Advances in Psychopharmacology最新文献

{"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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}

{"title":"Comment on: Treatment strategies for clozapine-induced hypotension: A systematic review.","authors":"Patrick M Wieruszewski,&nbsp;Erica D Wittwer,&nbsp;Sarah B Leung,&nbsp;Jonathan G Leung","doi":"10.1177/20451253221111682","DOIUrl":"https://doi.org/10.1177/20451253221111682","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":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2022-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b9/4c/10.1177_20451253221111682.PMC9301097.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40644863","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":"Exercise interventions to reduce anxiety in mid-life and late-life anxiety disorders and subthreshold anxiety disorder: a systematic review.","authors":"Terence W H Chong,&nbsp;Scherazad Kootar,&nbsp;Helen Wilding,&nbsp;Sarah Berriman,&nbsp;Eleanor Curran,&nbsp;Kay L Cox,&nbsp;Alex Bahar-Fuchs,&nbsp;Ruth Peters,&nbsp;Kaarin J Anstey,&nbsp;Christina Bryant,&nbsp;Nicola T Lautenschlager","doi":"10.1177/20451253221104958","DOIUrl":"https://doi.org/10.1177/20451253221104958","url":null,"abstract":"<p><strong>Background: </strong>Anxiety disorders are highly prevalent and cause significant distress, disability, and cost. Medication adverse effects and interactions increase in mid-life and late-life, highlighting the need for effective non-pharmacological interventions.</p><p><strong>Objectives: </strong>We aimed to evaluate the extent of evidence supporting exercise interventions for anxiety and subthreshold anxiety disorders in mid-life and late-life.</p><p><strong>Design: </strong>Systematic review.</p><p><strong>Data sources and methods: </strong>We searched MEDLINE, PsycINFO, Embase, Emcare, Ovid Nursing, CINAHL Plus, Cochrane Library, Health Collection, Humanities & Social Sciences Collection, and https://clinicaltrials.gov databases for trials published January 1994-May 2019. Randomised controlled trials of exercise interventions involving aerobic exercise or resistance training for adults aged 40 years and above with anxiety or subthreshold anxiety disorders in residential or health settings were identified. The primary outcome was change in anxiety. We excluded trials including participants aged below 40 years, participants with diagnosis of separation anxiety, selective mutism, obsessive-compulsive disorder, acute stress disorder and post-traumatic stress disorder, and head-to-head comparisons of interventions. Trial quality was assessed using the Cochrane Risk of Bias Tool and evidence synthesised in narrative form.</p><p><strong>Results: </strong>Four trials totalling 132 participants met inclusion criteria, although some had methodological limitations. Interventions included a home-based resistance training intervention, supervised group-based aerobic intervention, Tai Chi intervention, and supervised group-based aerobic and strength intervention. Three trials included late-life participants and the fourth mid-life. Three trials demonstrated greater reductions in anxiety in the intervention group compared with control. The fourth trial showed pre-post reductions in anxiety in both groups, with between-group difference not reaching statistical significance.</p><p><strong>Conclusion: </strong>There is limited supportive evidence suggesting that exercise interventions have potential to be effective, feasible and safe non-pharmacological interventions for anxiety and subthreshold anxiety disorders in mid-life and late-life. The heterogeneity, limited number and high risk of bias of some trials meant that we were not able to conduct a meta-analysis. Tailoring of interventions may improve uptake and reduce dropout. The paucity of research in this area with only four included trials demonstrates the urgent need for future and larger trials to provide proof of concept, data about effective types and doses of exercise interventions, and guidance to community, clinical, and public health services.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/24/7a/10.1177_20451253221104958.PMC9272174.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40504008","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":"Vortioxetine as adjunctive therapy in the treatment of schizophrenia.","authors":"Sofia Redaelli,&nbsp;Lilla Porffy,&nbsp;Ebenezer Oloyede,&nbsp;Olubanke Dzahini,&nbsp;Gabriella Lewis,&nbsp;Maria Lobo,&nbsp;Eromona Whiskey,&nbsp;Sukhi S Shergill","doi":"10.1177/20451253221110014","DOIUrl":"https://doi.org/10.1177/20451253221110014","url":null,"abstract":"<p><strong>Background: </strong>The evidence for safe and effective interventions to treat the negative and cognitive symptoms of schizophrenia is lacking.</p><p><strong>Objectives: </strong>Vortioxetine is a novel antidepressant that has been used as adjunctive therapy for the treatment of psychosis; however, its effectiveness in clinical practice is relatively unknown. In this study, we aimed to determine the potential clinical effectiveness and safety and tolerability of vortioxetine in psychosis.</p><p><strong>Design: </strong>This is a non-interventional, retrospective study on the add-on use of vortioxetine in a group of people with schizophrenia-spectrum disorders in a large UK NHS mental health trust.</p><p><strong>Methods: </strong>Clinical effectiveness of vortioxetine was retrospectively assessed through the Clinical Global Impression - Severity (CGI-S) scale at 3 months. Safety and tolerability were evaluated through treatment discontinuation rates at 3, 6, and 12 months, and clinical reasons were evaluated at the primary endpoint of 3 months.</p><p><strong>Results: </strong>Data were available for 40 subjects with a diagnosis of schizophrenia or schizoaffective disorder-prescribed vortioxetine treatment; 30 (75%) remained on treatment at 3 months. At CGI-S assessment, 15 of the 35 evaluated subjects reported at least a 1-point improvement, from 5 at baseline to 4 after 3 months of treatment. Twenty-six (65%) remained on treatment at 1-year follow-up. The main reasons for those discontinuing treatment were inadequate response (10%) and manic switch (7.5%), while one subject refused treatment. Tolerability to treatment was good, and 36 subjects (90%) reported no adverse events specific to vortioxetine treatment.</p><p><strong>Conclusion: </strong>Schizophrenia is a complex illness, and there is insufficient treatment response in many individuals. A significant proportion of whom may require adjunctive treatments depending on the nature of the residual symptoms. Vortioxetine could be a potentially safe and effective option in such people, but further controlled studies are required.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2022-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a2/45/10.1177_20451253221110014.PMC9272178.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40504007","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}