The introduction of the first antipsychotic drug, chlorpromazine, was a milestone for psychiatry. The authors review the history, classification, indications, mechanism, efficacy, side effects, dosing, drug initiation, switching, and other practical issues and questions related to antipsychotics. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
The authors used longitudinal biobank data with up to 25 years of follow-up on over 2,600 clozapine users to derive reliable estimates of the real-world burden of clozapine adverse drug events (ADEs). To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
This study examines the relative re-hospitalisation rates for mental health relapse and adverse events associated with clozapine and other antipsychotics in adult and child/youth cohorts. Open access article - no login required.
The aims of this study were to develop a population pharmacokinetic (PK) model for risperidone ISM® and to investigate the relationships between active moiety exposure, as described by apparent clearance (CL40), and several covariates using all data from five clinical studies. Open access article - no login required
This study uses habit formation models to investigate the dynamic interplay between psychosis, clozapine dose and obsessive–compulsive symptoms (OCS). Open access article - no login required.
Aripiprazole is recommended for routine use in schizophrenia patients. However, the biological mechanism for the adverse drug reactions (ADRs) among schizophrenia patients with the antipsychotic drug aripiprazole is far from clear. To explore the potential genetic factors that may cause movement-related adverse antipsychotic effects in patients, we conducted an association analysis between movement-related ADRs and SNPs in schizophrenia patients receiving aripiprazole monotherapy.
To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Although clozapine is the most efficacious medication for treatment-refractory schizophrenia, not all patients will have an adequate response. Optimising clozapine dose using therapeutic drug monitoring could therefore maximise response. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
The authors investigated transitions to schizophrenia spectrum or bipolar disorder following different types of substance-induced psychosis and the impact of gender, age, number of emergency admissions related to substance-induced psychosis, and type of substance-induced psychosis on such transitions. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
This study aimed to establish a prediction model of quetiapine concentration in patients with schizophrenia and depression, based on real-world data via machine learning techniques to assist clinical regimen decisions. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Guidance on clozapine dosing in treatment-resistant schizophrenia is based largely on data from White young adult males. This study aimed to investigate the pharmacokinetic profiles of clozapine and N-desmethylclozapine (norclozapine) across the age range, accounting for sex, ethnicity, smoking status, and body weight. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Based on the number needed to treat for the main study outcome, the authors concluded that 'for every 3 individuals continuing antipsychotic treatment at standard doses, one additional individual will avoid relapse compared to stopping antipsychotic treatment, which can be regarded as a large effect magnitude according to commonly used thresholds.'
Schizophrenia is associated with poor anticoagulation control and clinical prognosis in patients with atrial fibrillation (AF). Little is known about initiation of oral anticoagulation therapy (OAC) in this patient population. To read the full article, log in using your NHS OpenAthens details.
Cardiovascular disease risk in people with serious mental illness is higher than the general population, this risk is further increased in those with serious mental illness taking psychotropic medication. In this article, cardiovascular disease risk in serious mental illness, particularly the association with psychotropic interventions and monitoring required, is examined. To read the full article, log in using your NHS OpenAthens details.
Chris Hollis and colleagues' Article1 in The Lancet Psychiatry has many strengths. It addresses an important clinical question: does methylphenidate treatment for ADHD increase the risk of psychosis in patients with and without previous psychotic symptoms. Hollis and colleagues used Swedish national registers to review a large number (n=23 898) of health records, to examine the incidence of psychotic symptoms 12 weeks before, 12 weeks after, and 1 year after starting medication treatment, with a longitudinal within-subject study design. Their results indicated that methylphenidate treatment for ADHD does not increase psychotic symptoms in the short-term or long-term in patients with and without previous psychosis. There is some suggestion in their study that methylphenidate might, in fact, decrease the risk of a psychotic episode, particularly in patients with a history of psychosis. The findings of their study should therefore be reassuring to clinicians. However, as the authors themselves point out, the study has several limitations that could affect the reassuring message.. Please contact the library to request a copy of this article - http://bit.ly/2HjNDf3
There is a clinical concern that prescribing methylphenidate, the most common pharmacological treatment for attention-deficit hyperactivity disorder (ADHD), might increase the risk of psychotic events, particularly in young people with a history of psychosis. We aimed to determine whether the risk of psychotic events increases immediately after initiation of methylphenidate treatment or, in the longer term, 1 year after treatment initiation in adolescents and young adults with and without a previously diagnosed psychotic disorder.. Please contact the library to request a copy of this article - http://bit.ly/2HjNDf3
Samuele Cortese on psychosis ADHD, a recent study that looks at the comparative risk of psychosis during treatment with methylphenidate and amphetamines.
Open access journal. The effect of antipsychotic (AP) drugs on risk of stroke and myocardial infarction (MI) remains unclear due to methodological limitations of, and inconsistencies across, existing studies. We aimed to systematically review studies reporting on the associations between AP drug use and stroke or MI risk, and to investigate whether associations differed among different sub-populations.
To explore the temporal dynamic of antidepressant and antipsychotic co‐prescribing in real‐life conditions.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
Open access. ‘Rebound’ or ‘withdrawal’ symptoms are frequently observed after a sudden discontinuation of clozapine. We describe a patient with treatment-resistant schizoaffective disorder who developed agranulocytosis on clozapine but was successfully switched to treatment with olanzapine with no deterioration in her condition. We put forward three possible theories which may have accounted for the lack of rebound symptoms in this patient: the pharmacological profile of olanzapine, the anticholinergic effects of hyoscine hydrobromide, and the possibility that this patient may not be treatment-resistant and so have a reduced risk of rebound psychosis due to displaying a different pathophysiology.