The Journal of Clinical Psychiatry最新文献

{"title":"Very Low-Level Transcranial Photobiomodulation for Major Depressive Disorder: The ELATED-3 Multicenter, Randomized, Sham-Controlled Trial.","authors":"Dan V Iosifescu,&nbsp;Richard J Norton,&nbsp;Umit Tural,&nbsp;David Mischoulon,&nbsp;Katherine Collins,&nbsp;Erin McDonald,&nbsp;Luis De Taboada,&nbsp;Simmie Foster,&nbsp;Cristina Cusin,&nbsp;Albert Yeung,&nbsp;Alisabet Clain,&nbsp;David Schoenfeld,&nbsp;Michael R Hamblin,&nbsp;Paolo Cassano","doi":"10.4088/JCP.21m14226","DOIUrl":"https://doi.org/10.4088/JCP.21m14226","url":null,"abstract":"<p><p><b><i>Background:</i></b> Transcranial photobiomodulation (t-PBM) with near-infrared (NIR) light might represent a treatment for major depressive disorder (MDD). However, the dosimetry of administered t-PBM varies widely. We tested the efficacy of t-PBM with low irradiance, low energy per session, and low number of sessions in individuals with MDD.</p><p><p><b><i>Methods:</i></b> A 2-site, double-blind, sham-controlled study was conducted of adjunct t-PBM NIR (830 nm; continuous wave; 35.8 cm² treatment area; 54.8 mW/cm² irradiance; 65.8 J/cm² fluence, 20 min/session; ~2 W total power; 2.3 kJ total energy per session), delivered to the prefrontal cortex, bilaterally, twice a week for 6 weeks, in subjects diagnosed with MDD per the <i>DSM-IV</i> criteria. Subjects were recruited between August 2016 and May 2018. A sequential parallel comparison design was used: 18 nonresponders to sham in phase 1 (6 weeks) were re-randomized in phase 2. The primary outcome was reduction in depression severity (Hamilton Depression Rating Scale [HDRS-17] and Quick Inventory of Depressive Symptomatology-Clinician Rating [QIDS-C] scores) from baseline. Statistical analyses used R package SPCDAnalyze2, including all subjects with ≥ 1 post-randomization evaluation.</p><p><p><b><i>Results:</i></b> Of the 54 subjects recruited, we included 49 MDD subjects in the analysis (71% female, mean ± SD age 40.8 ± 16.1 years). There were no significant differences between t-PBM and sham with respect to the change in HDRS-17 (<i>t</i> = -0.319, <i>P</i> = .751) or QIDS-C (<i>t</i> = -0.499, <i>P</i> = .620) scores. The sham effect was reasonably low.</p><p><p><b><i>Conclusions:</i></b> Mostly uncontrolled studies suggest the efficacy of t-PBM for MDD; however, its optimal dose is still to be defined. A minimal dose threshold is likely necessary, similarly to other neuromodulation techniques in MDD (electroconvulsive therapy, transcranial magnetic stimulation). We established a threshold of inefficacy of t-PBM for MDD, based on combined low irradiance, low energy per session, and low number of sessions.</p><p><p><b><i>Trial Registration:</i></b> ClinicalTrials.gov identifier: NCT02959307.</p>","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40686045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tardive Dyskinesia and Long-Acting Injectable Antipsychotics: Analyses Based on a Spontaneous Reporting System Database in Japan.","authors":"Fuminari Misawa,&nbsp;Yasuo Fujii,&nbsp;Hiroyoshi Takeuchi","doi":"10.4088/JCP.21m14304","DOIUrl":"https://doi.org/10.4088/JCP.21m14304","url":null,"abstract":"<p><p><b><i>Objective:</i></b> This study compared the reporting frequency of tardive dyskinesia (TD) between long-acting injectable antipsychotics (LAI-APs) and the equivalent oral antipsychotics (O-APs), LAI first-generation antipsychotics (LAI-FGAs) and LAI second-generation antipsychotics (LAI-SGAs), and individual LAI-APs.</p><p><p><b><i>Methods:</i></b> The Japanese Adverse Drug Event Report was used in this study, and data were obtained from April 2004 to February 2021. Patients who received LAI-APs available in Japan (LAI haloperidol, LAI fluphenazine, LAI aripiprazole, LAI risperidone, and LAI paliperidone) or the equivalent O-APs were included in this study. We calculated the adjusted reporting odds ratios (aRORs) to compare the reporting frequency of TD.</p><p><p><b><i>Results:</i></b> A total of 8,425 patients were included in the study. TD was reported significantly less frequently with LAI paliperidone than with oral paliperidone (aROR [95% confidence interval (CI)] = 0.13 [0.05-0.36]). Other LAI-APs were associated with a numerically lower reporting frequency of TD than the equivalent oral SGAs. The reporting frequency of TD associated with LAI-SGAs was significantly lower than that of LAI-FGAs (aROR [95% CI] = 0.18 [0.08-0.43]). All LAI-SGAs were significantly associated with a lower reporting frequency of TD than that of LAI fluphenazine (aROR [95% CI]: LAI aripiprazole, 0.11 [0.04-0.35]; LAI risperidone, 0.09 [0.03-0.32]; LAI paliperidone, 0.02 [0.005-0.09]). and LAI haloperidol, 8.58 [1.85-39.72]). LAI fluphenazine was significantly associated with a higher reporting frequency of TD than LAI haloperidol (aROR [95% CI] = 8.58 [1.85-39.72]). The reporting frequency of TD associated with LAI paliperidone was significantly lower than that with LAI aripiprazole (aROR [95% CI] = 0.18 [0.05-0.73]).</p><p><p><b><i>Conclusions:</i></b> Compared to O-APs, LAI-APs, particularly LAI-SGAs, may be associated with a lower risk of TD.</p>","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40580014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabidiol for Treatment-Resistant Anxiety Disorders in Young People: An Open-Label Trial.","authors":"Maximus Berger,&nbsp;Emily Li,&nbsp;Simon Rice,&nbsp;Christopher G Davey,&nbsp;Aswin Ratheesh,&nbsp;Sophie Adams,&nbsp;Henry Jackson,&nbsp;Sarah Hetrick,&nbsp;Alexandra Parker,&nbsp;Tim Spelman,&nbsp;Richard Kevin,&nbsp;Iain S McGregor,&nbsp;Patrick McGorry,&nbsp;G Paul Amminger","doi":"10.4088/JCP.21m14130","DOIUrl":"https://doi.org/10.4088/JCP.21m14130","url":null,"abstract":"<p><p><b><i>Background:</i></b> Treatment resistance is a significant problem among young people experiencing moderate-to-severe anxiety, affecting nearly half of all patients. This study investigated the safety and efficacy of cannabidiol (CBD), a non-intoxicating component of <i>Cannabis sativa</i>, for anxiety disorders in young people who previously failed to respond to standard treatment.</p><p><p><b><i>Methods:</i></b> In this open-label trial, 31 young people aged 12-25 years with a <i>DSM-5</i> anxiety disorder and no clinical improvement despite treatment with cognitive-behavioral therapy and/or antidepressant medication were enrolled between May 16, 2018, and June 28, 2019. All participants received add-on CBD for 12 weeks on a fixed-flexible schedule titrated up to 800 mg/d. The primary outcome was improvement in anxiety severity, measured with the Overall Anxiety Severity and Impairment Scale (OASIS), at week 12. Secondary outcomes included comorbid depressive symptoms, Clinical Global Impressions scale (CGI) score, and social and occupational functioning.</p><p><p><b><i>Results:</i></b> Mean (SD) OASIS scores decreased from 10.8 (3.8) at baseline to 6.3 (4.5) at week 12, corresponding to a -42.6% reduction (<i>P</i> < .0001). Depressive symptoms (<i>P</i> < .0001), CGI-Severity scale scores (<i>P</i> = .0008), and functioning (<i>P</i> = .04) improved significantly. Adverse events were reported in 25 (80.6%) of 31 participants and included fatigue, low mood, and hot flushes or cold chills. There were no serious and/or unexpected adverse events.</p><p><p><b><i>Conclusions:</i></b> These findings suggest that CBD can reduce anxiety severity and has an adequate safety profile in young people with treatment-resistant anxiety disorders. Randomized controlled trials are needed to confirm the efficacy and longer-term safety of this compound.</p><p><p><b><i>Trial R</i></b><b><i>egistration:</i></b> New Zealand Clinical Trials Registry (ANZCTR) identifier: ACTRN12617000825358.</p>","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40580012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Functioning and Life Engagement: Unmet Needs in Major Depressive Disorder and Schizophrenia.","authors":"Christoph U Correll,&nbsp;Zahinoor Ismail,&nbsp;Roger S McIntyre,&nbsp;Roueen Rafeyan,&nbsp;Michael E Thase","doi":"10.4088/JCP.LU21112AH1","DOIUrl":"https://doi.org/10.4088/JCP.LU21112AH1","url":null,"abstract":"<p><p>Definitions of treatment success used in clinical trials of medications for serious mental illness have generally focused on reduction in symptoms assessed via observer-rated instruments such as the Montgomery-Asberg Depression Rating Scale and the Hamilton Depression Rating Scale in MDD and the Positive and Negative Syndrome Scale (PANSS) and Brief Psychiatric Rating Scale in schizophrenia. In recent years, there has been a shift toward incorporating outcomes into clinical research that are patient-reported and reflect outcomes and goals that are meaningful to the patient. These outcomes include aspects of functioning (eg, activities of daily living and role fulfillment), as well as life engagement, which interacts with symptomatic and functional outcomes and encompasses aspects such as motivation and vitality. In a recent roundtable meeting, a panel of 5 experts discussed life engagement and its relationship to symptoms and functioning in patients with major depressive disorder (MDD) and schizophrenia. This Academic Highlights summarizes their discussion.</p>","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40580013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychotropic Drugs With Long Half-Lives: Implications for Drug Discontinuation, Occasional Missed Doses, Dosing Interval, and Pregnancy Planning.","authors":"Chittaranjan Andrade","doi":"10.4088/JCP.22f14593","DOIUrl":"https://doi.org/10.4088/JCP.22f14593","url":null,"abstract":"<p><p>The half-life of a drug is the time taken for the blood level of the drug to fall by half, provided that no more doses of the drug are administered in the intervening period. Many psychotropic drugs and their active metabolites, if any, have very long half-lives that extend for 2 days or longer. Examples are chlordiazepoxide, diazepam, fluoxetine, vortioxetine, aripiprazole, brexpiprazole, cariprazine, penfluridol, donepezil, and memantine. Other drugs with long half-lives that psychiatrists may prescribe include levothyroxine and zonisamide. Psychotropic drugs with long half-lives take long to reach steady state; this is seldom a problem. They also take long to wash out; this is an advantage because the risk of drug withdrawal or discontinuation syndromes is small, and a disadvantage if rapid washout is desired for any reason, including the experience of drug adverse effects or toxicity, or the discovery of an unplanned pregnancy. Other clinical issues related to drugs with long half-lives include the relevance of occasional missed doses, the possibility of once-weekly dosing, and the need for pregnancy planning.</p>","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40580575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Add-On Pramipexole for the Treatment of Schizophrenia and Schizoaffective Disorder: A Randomized Controlled Trial.","authors":"Linda Levi,&nbsp;Daisy Zamora,&nbsp;Igor Nastas,&nbsp;Ilan Gonen,&nbsp;Paull Radu,&nbsp;Valentin Matei,&nbsp;Adela M Ciobanu,&nbsp;Anatol Nacu,&nbsp;Larisa Boronin,&nbsp;Lusian Karakrah,&nbsp;Michael Davidson,&nbsp;John M Davis,&nbsp;Mark Weiser","doi":"10.4088/JCP.21m14233","DOIUrl":"https://doi.org/10.4088/JCP.21m14233","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Several small clinical trials have reported that the dopamine agonist pramipexole was beneficial in treating patients with schizophrenia. A confirmatory trial was conducted to test this hypothesis.</p><p><p><b><i>Methods:</i></b> This 16-week, multicenter, double-blind, randomized, placebo-controlled study included 200 subjects meeting <i>DSM-IV-TR</i> criteria for schizophrenia or schizoaffective disorder. Patients were randomized to receive either pramipexole (0.75 mg twice daily, n = 100) or placebo (n = 100) as an add-on to their regular antipsychotic treatment. The primary outcome measure was the total score on the Positive and Negative Syndrome Scale (PANSS); secondary outcome measures included PANSS subscale and cognitive functioning scores. Recruitment was performed in 30 sites in Romania and 1 site in the Republic of Moldova between January and June 2011.</p><p><p><b><i>Results:</i></b> Analysis of covariance models showed no significant difference between pramipexole and placebo for total PANSS (<i>P</i> > .99) and PANSS positive (<i>P</i> > .99), negative (<i>P</i> = .73), and general psychopathology (<i>P</i> = .99) subscale scores. Changes in Clinical Global Impressions-Severity of Illness scale and Brief Assessment of Cognition in Schizophrenia scores showed no significant difference between pramipexole and placebo.</p><p><p><b><i>Conclusions:</i></b> The results of this large randomized controlled trial indicated that pramipexole was not efficacious as an add-on to antipsychotic medications for schizophrenia.</p><p><p><b><i>Trial Registration:</i></b> ClinicalTrials.gov identifier NCT01320982.</p>","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40580577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timely Diagnosis of Alzheimer Disease.","authors":"Anna D Burke,&nbsp;Danielle Goldfarb","doi":"10.4088/JCP.LI21019DH1C","DOIUrl":"https://doi.org/10.4088/JCP.LI21019DH1C","url":null,"abstract":"<p><p>Diagnosing early-stage Alzheimer disease can lead to prompt initiation of treatment and slow down symptom progression. However, clinicians are not providing a diagnosis to over half of individuals who meet criteria for dementia. Tests for biomarkers, new symptomatic treatments and disease-modifying agents, and the addition of the preclinical stage to the diagnostic criteria for AD can aid in earlier disease recognition and developing treatment plans. Communicating diagnosis and information on next steps with patients and caregivers can lead to patient and caregiver involvement in decision-making and planning as well as participation in clinical trials and maximizing benefits and lifestyle interventions.</p>","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40580576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitating Treatment Initiation in Early-Stage Alzheimer Disease.","authors":"Anna D Burke,&nbsp;Danielle Goldfarb","doi":"10.4088/JCP.LI21019DH2C","DOIUrl":"https://doi.org/10.4088/JCP.LI21019DH2C","url":null,"abstract":"<p><p>Once a diagnosis of Alzheimer disease is established, a wide variety of therapy options are available to treat different stages of the disease. Patients have the opportunity to delay onset of the disease or delay its progression if diagnosed early enough through new FDA-approved disease-modifying treatments. For mild to moderate stages, new symptomatic treatments can slow the progression of the disease and improve symptoms. A multi-component approach is recommended in order to tailor treatments to each patient's needs.</p>","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40580009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Scores on the Montgomery-Åsberg Depression Rating Scale and Psychotic Symptoms Predict Suicide: A Prospective Cohort Study of Psychiatric Acute Ward Patients.","authors":"Kristin J Fredriksen,&nbsp;Rolf Gjestad,&nbsp;Fredrik A Walby,&nbsp;Liss G Anda,&nbsp;Ketil J Oedegaard,&nbsp;Helle K Schoeyen","doi":"10.4088/JCP.21m14018","DOIUrl":"https://doi.org/10.4088/JCP.21m14018","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To investigate the role of depression severity in suicide risk by studying the predictive value of psychotic symptoms and depression scale scores, controlled for suicidal behavior and gender.</p><p><p><b><i>Methods:</i></b> We conducted a prospective cohort study of consecutive psychiatric acute ward admissions between 2005 and 2014 from a Norwegian catchment area. Inclusion criteria were an <i>ICD-10</i> diagnosis of unipolar or bipolar depression with a current depressive episode (n = 1,846); depression severity was measured by the Montgomery-Åsberg Depression Rating Scale (MADRS). Patients were assessed for suicidal ideation/planning, self-harm, and recent suicide attempts on admission. Mean follow-up time was 5.5 years (minimum/maximum: 0/10.6 years). We used Cox regression analyses and Kaplan-Meier analyses to explore potential predictors and time to suicide.</p><p><p><b><i>Results:</i></b> During the follow-up period, 46 patients died by suicide, 30 (65%) of these within the year following admission. Psychotic depression (<i>P</i> = .014), admission MADRS score (<i>P</i> = .006), suicide attempts (<i>P</i> = .021), and male sex (<i>P</i> = .043) significantly predicted suicide. Suicidal ideation and self-harm did not predict suicide. The cumulative suicide risk in psychotic depression was 1.7% after 12 weeks and 3.0% after 52 weeks.</p><p><p><b><i>Conclusions:</i></b> Depression severity as measured with the MADRS or a diagnosis of psychotic depression independently predicted suicide. More suicides may be prevented by implementing intensive treatment and post-discharge follow-up for patients who present to psychiatric acute wards with severe depressive episodes and recent suicide attempts, regardless of self-reported suicidal ideation, suicide plans, and self-harm.</p>","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40555112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Practical Importance of Half-Life in Psychopharmacology.","authors":"Chittaranjan Andrade","doi":"10.4088/JCP.22f14584","DOIUrl":"https://doi.org/10.4088/JCP.22f14584","url":null,"abstract":"<p><p>The half-life of a drug is most commonly defined as the time taken for the plasma or blood level of the drug to fall by half. Elimination half-life, pharmacologic half-life, and biologic half-life are interchangeably used most commonly to describe the half-life of drugs that follow first-order or linear pharmacokinetics; that is, in single-compartment models, where the fall in blood level is proportionate to the concentration of the drug in blood. In 2 compartment models, where the drug equilibrates between blood and (for example) adipose tissue, during elimination there is a sharp initial fall in blood levels followed by a gradual subsequent fall; when drugs display this biphasic elimination pattern, the half-life corresponding to the second phase is what is clinically relevant, and this half-life is known as the terminal half-life. Half-life is influenced by drug distribution, drug metabolism, and drug excretion, each of which can be influenced by many factors such as age, use of concurrent medications, and presence of liver or renal disease. In order to maintain uniform blood levels and reduce the adverse effect risk, drugs with short half-lives need to be dosed more frequently. Drugs with short half-lives are more likely to be associated with withdrawal or discontinuation syndromes. The duration of action of a drug, time to steady state levels, and time to washout are each influenced by the value of the drug half-life. All these terms and concepts are defined and explained with the help of clinically relevant examples. Mental health care professionals who prescribe to patients need to know the half-lives of the drugs that they prescribe, the half-lives of active metabolites, if any, how these half-lives may differ with individual patient characteristics, and how to use this knowledge to prescribe to best advantage.</p>","PeriodicalId":516853,"journal":{"name":"The Journal of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2022-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40555114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}