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Original Research Published, Reproduced, Transmitted, Modified, Posted, Sold, Licensed, Or Used for Commercial Purposes
This work may not be copied, distributed, displayed, Original Research published, reproduced, transmitted, modified, posted, sold, licensed, or used for commercial purposes. By downloading this file, you are agreeing to the Efficacy and Effectiveness of Depot publisher’s Terms & Conditions. Versus Oral Antipsychotics in Schizophrenia: Synthesizing Results Across Different Research Designs Noam Y. Kirson, PhD; Peter J. Weiden, MD; Sander Yermakov, MS; Wayne Huang, MPP; Thomas Samuelson, BA; Steve J. Offord, PhD; Paul E. Greenberg, MS, MA; and Bruce J. O. Wong, MD ABSTRACT he cornerstone of long-term maintenance therapy Objective: Nonadherence is a major challenge in schizophrenia Tof schizophrenia patients is relapse prevention. treatment. While long-acting (depot) antipsychotic medications are Relapse prevention is necessary—albeit not sufficient— often recommended to address adherence problems, evidence on for eventual successful rehabilitation.1 In practice, the the comparative effectiveness of depot versus oral antipsychotics is effectiveness of maintenance antipsychotic treatment is inconsistent. We hypothesize that this inconsistency could be due to often undermined by poor adherence to therapy. Not systematic differences in study design. This review evaluates the effect only is nonadherence the single greatest modifiable of study design on the comparative effectiveness of antipsychotic risk factor for relapse,2,3 it is also often undetected, formulations. The optimal use of different antipsychotic formulations resulting in lost opportunities to employ psychosocial in a general clinical setting depends on better understanding of the underlying reasons for differences in effectiveness across research interventions for adherence, as well as uncertainty as designs. to the relative contribution of lack of efficacy versus Data Sources: A PubMed literature review targeted English-language adherence problems to poor outcomes. -
Clomipramine | Memorial Sloan Kettering Cancer Center
PATIENT & CAREGIVER EDUCATION Clomipramine This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider. Brand Names: US Anafranil Brand Names: Canada Anafranil; MED ClomiPRAMINE; TARO-Clomipramine Warning Drugs like this one have raised the chance of suicidal thoughts or actions in children and young adults. The risk may be greater in people who have had these thoughts or actions in the past. All people who take this drug need to be watched closely. Call the doctor right away if signs like low mood (depression), nervousness, restlessness, grouchiness, panic attacks, or changes in mood or actions are new or worse. Call the doctor right away if any thoughts or actions of suicide occur. This drug is not approved for use in all children. Talk with the doctor to be sure that this drug is right for your child. What is this drug used for? It is used to treat obsessive-compulsive problems. It may be given to you for other reasons. Talk with the doctor. Clomipramine 1/8 What do I need to tell my doctor BEFORE I take this drug? If you have an allergy to clomipramine or any other part of this drug. If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had. If you have had a recent heart attack. If you are taking any of these drugs: Linezolid or methylene blue. -
Specificity of Psychosis, Mania and Major Depression in A
Molecular Psychiatry (2014) 19, 209–213 & 2014 Macmillan Publishers Limited All rights reserved 1359-4184/14 www.nature.com/mp ORIGINAL ARTICLE Specificity of psychosis, mania and major depression in a contemporary family study CL Vandeleur1, KR Merikangas2, M-PF Strippoli1, E Castelao1 and M Preisig1 There has been increasing attention to the subgroups of mood disorders and their boundaries with other mental disorders, particularly psychoses. The goals of the present paper were (1) to assess the familial aggregation and co-aggregation patterns of the full spectrum of mood disorders (that is, bipolar, schizoaffective (SAF), major depression) based on contemporary diagnostic criteria; and (2) to evaluate the familial specificity of the major subgroups of mood disorders, including psychotic, manic and major depressive episodes (MDEs). The sample included 293 patients with a lifetime diagnosis of SAF disorder, bipolar disorder and major depressive disorder (MDD), 110 orthopedic controls, and 1734 adult first-degree relatives. The diagnostic assignment was based on all available information, including direct diagnostic interviews, family history reports and medical records. Our findings revealed specificity of the familial aggregation of psychosis (odds ratio (OR) ¼ 2.9, confidence interval (CI): 1.1–7.7), mania (OR ¼ 6.4, CI: 2.2–18.7) and MDEs (OR ¼ 2.0, CI: 1.5–2.7) but not hypomania (OR ¼ 1.3, CI: 0.5–3.6). There was no evidence for cross-transmission of mania and MDEs (OR ¼ .7, CI:.5–1.1), psychosis and mania (OR ¼ 1.0, CI:.4–2.7) or psychosis and MDEs (OR ¼ 1.0, CI:.7–1.4). -
Revision of Precautions Asenapine Maleate, Aripiprazole, Olanzapine
Published by Translated by Ministry of Health, Labour and Welfare Pharmaceuticals and Medical Devices Agency This English version is intended to be a reference material to provide convenience for users. In the event of inconsistency between the Japanese original and this English translation, the former shall prevail. Revision of Precautions Asenapine maleate, aripiprazole, olanzapine, quetiapine fumarate, clocapramine hydrochloride hydrate, chlorpromazine hydrochloride, chlorpromazine hydrochloride/promethazine hydrochloride/phenobarbital, chlorpromazine phenolphthalinate, spiperone, zotepine, timiperone, haloperidol, paliperidone, pipamperone hydrochloride, fluphenazine decanoate, fluphenazine maleate, brexpiprazole, prochlorperazine maleate, prochlorperazine mesilate, Pharmaceuticals and Medical Devices Agency Office of Safety I 3-3-2 Kasumigaseki, Chiyoda-ku, Tokyo 100-0013 Japan E-mail: [email protected] Published by Translated by Ministry of Health, Labour and Welfare Pharmaceuticals and Medical Devices Agency This English version is intended to be a reference material to provide convenience for users. In the event of inconsistency between the Japanese original and this English translation, the former shall prevail. propericiazine, bromperidol, perphenazine, perphenazine hydrochloride, perphenazine fendizoate, perphenazine maleate, perospirone hydrochloride hydrate, mosapramine hydrochloride, risperidone (oral drug), levomepromazine hydrochloride, levomepromazine maleate March 27, 2018 Non-proprietary name Asenapine maleate, -
Is Aristada (Aripiprazole Lauroxil) a Safe and Effective Treatment for Schizophrenia in Adult Patients? Kyle J
Philadelphia College of Osteopathic Medicine DigitalCommons@PCOM PCOM Physician Assistant Studies Student Student Dissertations, Theses and Papers Scholarship 2017 Is Aristada (Aripiprazole Lauroxil) a Safe and Effective Treatment For Schizophrenia In Adult Patients? Kyle J. Knowles Philadelphia College of Osteopathic Medicine Follow this and additional works at: https://digitalcommons.pcom.edu/pa_systematic_reviews Part of the Psychiatry Commons Recommended Citation Knowles, Kyle J., "Is Aristada (Aripiprazole Lauroxil) a Safe and Effective Treatment For Schizophrenia In Adult Patients?" (2017). PCOM Physician Assistant Studies Student Scholarship. 381. https://digitalcommons.pcom.edu/pa_systematic_reviews/381 This Selective Evidence-Based Medicine Review is brought to you for free and open access by the Student Dissertations, Theses and Papers at DigitalCommons@PCOM. It has been accepted for inclusion in PCOM Physician Assistant Studies Student Scholarship by an authorized administrator of DigitalCommons@PCOM. For more information, please contact [email protected]. Is Aristada (Aripiprazole Lauroxil) a Safe and Effective Treatment For Schizophrenia In Adult Patients? Kyle J. Knowles, PA-S A SELECTIVE EVIDENCE BASED MEDICINE REVIEW In Partial Fulfillment of the Requirements For The Degree of Master of Science In Health Sciences- Physician Assistant Department of Physician Assistant Studies Philadelphia College of Osteopathic Medicine Philadelphia, Pennsylvania December 16, 2016 ABSTRACT OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is Aristada (aripiprazole lauroxil) a safe and effective treatment for schizophrenia in adult patients?” STUDY DESIGN: Review of three randomized controlled studies. All three trials were conducted between 2014 and 2015. DATA SOURCES: One randomized, controlled trial and two randomized, controlled, double- blind trials found via Cochrane Library and PubMed. -
Antidepressants the Old and the New
Antidepressants The Old and The New October, 1998 iii In 1958 researchers discovered that imipramine had antidepressant 1 activity. Since then, a number of antidepressants have been HIGHLIGHTS developed with a variety of pharmacological mechanisms and side effect profiles. All antidepressants show similar efficacy in the treatment of depression when used in adequate dosages. Choosing the most PHARMACOLOGY & CLASSIFICATION appropriate agent depends on specific patient variables, The mechanism of action for antidepressants is not entirely clear; concurrent diseases, concurrent drugs, and cost. however they are known to interfere with neurotransmitters. Non-TCA antidepressants such as the SSRIs have become Tricyclic antidepressants (TCAs) block the reuptake of both first line agents in the treatment of depression due to their norepinephrine (NE) and serotonin (5HT). The relative ratio of relative safety and tolerability. Each has its own advantages and their effect on NE versus 5HT varies. The potentiation of NE and disadvantages for consideration in individualizing therapy. 5HT results in changes in the neuroreceptors and is thought to be TCAs may be preferred in patients who do not respond to or the primary mechanism responsible for the antidepressant effect. tolerate other antidepressants, have chronic pain or migraine, or In addition to the effects on NE and 5HT, TCAs also block for whom drug cost is a significant factor. muscarinic, alpha1 adrenergic, and histaminic receptors. The extent of these effects vary with each agent resulting in differing Secondary amine TCAs (desipramine and nortriptyline) have side effect profiles. fewer side effects than tertiary amine TCAs. Maintenance therapy at full therapeutic dosages should be Selective serotonin-reuptake inhibitors (SSRIs) block the 2 considered for patients at high risk for recurrence. -
A Brief Overview of Psychiatric Pharmacotherapy
A Brief Overview of Psychiatric Pharmacotherapy Joel V. Oberstar, M.D. Chief Executive Officer Disclosures • Some medications discussed are not approved by the FDA for use in the population discussed/described. • Some medications discussed are not approved by the FDA for use in the manner discussed/described. • Co-Owner: – PrairieCare and PrairieCare Medical Group – Catch LLC Disclaimer The contents of this handout are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical or psychiatric condition. Never disregard professional/medical advice or delay in seeking it because of something you have read in this handout. Material in this handout may be copyrighted by the author or by third parties; reasonable efforts have been made to give attribution where appropriate. Caveat Regarding the Role of Medication… Neuroscience Overview Mind Over Matter, National Institute on Drug Abuse, National Institutes of Health. Available at: http://teens.drugabuse.gov/mom/index.asp. http://medicineworld.org/images/news-blogs/brain-700997.jpg Neuroscience Overview Mind Over Matter, National Institute on Drug Abuse, National Institutes of Health. Available at: http://teens.drugabuse.gov/mom/index.asp. Neurotransmitter Receptor Source: National Institute on Drug Abuse Common Diagnoses and Associated Medications • Psychotic Disorders – Antipsychotics • Bipolar Disorders – Mood Stabilizers, Antipsychotics, & Antidepressants • Depressive Disorders – Antidepressants • Anxiety Disorders – Antidepressants & Anxiolytics • Attention Deficit Hyperactivity Disorder – Stimulants, Antidepressants, 2-Adrenergic Agents, & Strattera Classes of Medications • Anti-depressants • Stimulants and non-stimulant alternatives • Anti-psychotics (a.k.a. -
Psychotropic Medication Concerns When Treating Individuals with Developmental Disabilities
Tuesday, 2:30 – 4:00, C2 Psychotropic Medication Concerns when Treating Individuals with Developmental Disabilities Richard Berchou 248-613-6716 [email protected] Objective: Identify effective methods for the practical application of concepts related to improving the delivery of services for persons with developmental disabilities Notes: Medication Assistance On-Line Resources OBTAINING MEDICATION: • Needy Meds o Needymeds.com • Partnership for Prescriptions Assistance o Pparx.org • Patient Assistance Program Center o Rxassist.org • Insurance coverage & Prior authorization forms for most drug plans o Covermymeds.com REMINDERS TO TAKE MEDICATION: • Medication reminder by Email, Phone call, or Text message o Sugaredspoon.com ANSWER MOST QUESTIONS ABOUT MEDICATIONS: • Univ. of Michigan/West Virginia Schools of Pharmacy o Justaskblue.com • Interactions between medications, over-the-counter (OTC) products and some foods; also has a pictorial Pill Identifier: May input an entire list of medications o Drugs.com OTHER TRUSTED SITES: • Patient friendly information about disease and diagnoses o Mayoclinic.com, familydoctor.org • Package inserts, boxed warnings, “Dear Doctor” letters (can sign up to receive e- mail alerts) o Dailymed.nlm.nih.gov • Communications about drug safety o www.Fda.gov/cder/drug/drugsafety/drugindex.htm • Purchasing medications on-line o Pharnacychecker.com Updated 2013 Psychotropic Medication for Persons with Developmental Disabilities April 23, 2013 Richard Berchou, Pharm. D. Assoc. Clinical Prof., Dept. Psychiatry & Behavioral -
Which Is It: ADHD, Bipolar Disorder, Or PTSD?
HEALINGHEALINGA PUBLICATION OF THE HCH CLINICIANS’ HANDSHANDS NETWORK Vol. 10, No. 3 I August 2006 Which Is It: ADHD, Bipolar Disorder, or PTSD? Across the spectrum of mental health care, Anxiety Disorders, Attention Deficit Hyperactivity Disorders, and Mood Disorders often appear to overlap, as well as co-occur with substance abuse. Learning to differentiate between ADHD, bipolar disorder, and PTSD is crucial for HCH clinicians as they move toward integrated primary and behavioral health care models to serve homeless clients. The primary focus of this issue is differential diagnosis. Readers interested in more detailed clinical information about etiology, treatment, and other interventions are referred to a number of helpful resources listed on page 6. HOMELESS PEOPLE & BEHAVIORAL HEALTH Close to a symptoms exhibited by clients with ADHD, bipolar disorder, or quarter of the estimated 200,000 people who experience long-term, PTSD that make definitive diagnosis formidable. The second chronic homelessness each year in the U.S. suffer from serious mental causative issue is how clients’ illnesses affect their homelessness. illness and as many as 40 percent have substance use disorders, often Understanding that clinical and research scientists and social workers with other co-occurring health problems. Although the majority of continually try to tease out the impact of living circumstances and people experiencing homelessness are able to access resources comorbidities, we recognize the importance of causal issues but set through their extended family and community allowing them to them aside to concentrate primarily on how to achieve accurate rebound more quickly, those who are chronically homeless have few diagnoses in a challenging care environment. -
The American Journal Of
The American Journal of Psychiatry Residents’ Journal July 2015 Volume 10 Issue 7 Inside IN THIS ISSUE 2 New Formats and New Opportunities: The Time to Get Involved is “Now”! Rajiv Radhakrishnan, M.B.B.S., M.D. 3 Prevention of Posttraumatic Stress Disorder: Predicting Response to Trauma Jennifer H. Harris, M.D. 7 Weight Gain in Patients With Schizophrenia: A Recipe For Timely Intervention Ammar El Sara, M.B.Ch.B. 10 Hyperprolactinemia and Antipsychotics: Update for the Training Psychiatrist Stephanie Pope, M.D. 13 A Clinical Case Conference on Spiritual Growth and Healing Elizabeth S. Stevens, D.O. This issue of the Residents’ Journal features a variety of topics. Jennifer H. Har- ris, M.D., discusses prevention of posttraumatic stress disorder, with an overview 15 Priapism: A Rare but Serious of various responses to trauma. Ammar El Sara, M.B.Ch.B., presents a review of Side Effect of Trazodone clinically applicable evidence-based interventions targeting obesity in schizophre- Kamalika Roy, M.D. nia patients. Stephanie Pope, M.D., examines antipsychotic-induced hyperprolac- 17 Classifying Psychopathology: tinemia, including variables affecting prolactin and clinical implications. Elizabeth Mental Kinds and Natural Kinds S. Stevens, D.O., discusses several psychological, social, and spiritual developmen- Reviewed by Aaron J. Hauptman, tal frameworks in a clinical case conference. Kamalika Roy, M.D., presents a case M.D. of priapism as a side effect of trazodone in a middle-aged patient. Lastly, Aaron J. Hauptman, M.D., offers his review of the book Classifying Psychopathology: Mental 18 Residents’ Resources Kinds and Natural Kinds. Editor-in-Chief Associate Editors Editors Emeriti Rajiv Radhakrishnan, M.B.B.S., M.D. -
Adverse Effects of First-Line Pharmacologic Treatments of Major Depression in Older Adults
Draft Comparative Effectiveness Review Number xx Adverse Effects of First-line Pharmacologic Treatments of Major Depression in Older Adults Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov This information is distributed solely for the purposes of predissemination peer review. It has not been formally disseminated by the Agency for Healthcare Research and Quality. The findings are subject to change based on the literature identified in the interim and peer-review/public comments and should not be referenced as definitive. It does not represent and should not be construed to represent an Agency for Healthcare Research and Quality or Department of Health and Human Services (AHRQ) determination or policy. Contract No. 290-2015-00012I Prepared by: Will be included in the final report Investigators: Will be included in the final report AHRQ Publication No. xx-EHCxxx <Month, Year> ii Purpose of the Review To assess adverse events of first-line antidepressants in the treatment of major depressive disorder in adults 65 years or older. Key Messages • Acute treatment (<12 weeks) with o Serotonin norepinephrine reuptake inhibitors (SNRIs) (duloxetine, venlafaxine), but not selective serotonin reuptake inhibitors (SSRIs) (escitalopram, fluoxetine) led to a greater number of adverse events compared with placebo. o SSRIs (citalopram, escitalopram and fluoxetine) and SNRIs (duloxetine and venlafaxine) led to a greater number of patients withdrawing from studies due to adverse events compared with placebo o Details of the contributing adverse events in RCTs were rarely reported to more clearly characterize what adverse events to expect. -
Generalized Anxiety Disorder: Practical Assessment and Management MICHAEL G
Generalized Anxiety Disorder: Practical Assessment and Management MICHAEL G. KAVAN, PhD; GARY N. ELSASSER, PharmD; and EUGENE J. BARONE, MD Creighton University School of Medicine, Omaha, Nebraska Generalized anxiety disorder is common among patients in primary care. Affected patients experience excessive chronic anxiety and worry about events and activities, such as their health, family, work, and finances. The anxiety and worry are difficult to control and often lead to physiologic symptoms, including fatigue, muscle tension, restless- ness, and other somatic complaints. Other psychiatric problems (e.g., depression) and nonpsychiatric factors (e.g., endocrine disorders, medication adverse effects, withdrawal) must be considered in patients with possible generalized anxiety disorder. Cognitive behavior therapy and the first-line pharmacologic agents, selective serotonin reuptake inhibitors, are effective treatments. However, evidence suggests that the effects of cognitive behavior therapy may be more durable. Although complementary and alternative medicine therapies have been used, their effectiveness has not been proven in generalized anxiety disorder. Selection of the most appropriate treatment should be based on patient preference, treatment success history, and other factors that could affect adherence and subsequent effective- ness. (Am Fam Physician. 2009;79(9):785-791. Copyright © 2009 American Academy of Family Physicians.) ▲ Patient information: nxiety disorders, such as generalized GAD is 3.1 percent in population-based sur-