DOCSLIB.ORG

Asenapine (Saphris) for Schizophrenia January 2010

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Asenapine (Saphris) for Schizophrenia January 2010 Asenapine (Saphris) for schizophrenia January 2010 This technology summary is based on information available at the time of research and a limited literature search. It is not intended to be a definitive statement on the safety, efficacy or effectiveness of the health technology covered and should not be used for commercial purposes. The National Horizon Scanning Centre Research Programme is part of the National Institute for Health Research January 2010 Asenapine (Saphris) for schizophrenia Target group • Schizophrenia: acute and maintenance treatment. Technology description Asenapine (Saphris, Sycrest, Org-5222) belongs to pyrrolidino tetracyclic class of atypical antipsychotics. It has potent antagonist properties for dopamine serotonin and adrenergic receptors. Asenapine is intended as a substitute for currently available atypical antipsychotics. Asenapine is administered sublingually at 5-10mg twice daily. Asenapine is launched for the acute treatment of both schizophrenia and manic or mixed episodes associated with bipolar I disorder in the USA. It is also in phase III clinical trials for manic episodes associated with bipolar I disorder in the EU and for treatment of psychosis in elderly patients in the USA. Innovation and/or advantages If licensed, asenapine will be the first drug for this indication with a sublingual route of administration, although there are other licensed atypical antipsychotics agents with orodispersable formulation. Developer Schering-Plough (a part of MSD). Availability, launch or marketing dates, and licensing plans An application for a Marketing Authorisation has been filed with the EMEA. NHS or Government priority area This topic is relevant to New Horizons: A Shared Vision for Mental Health (2009) and The National Service Framework for Mental Health: Modern Standards and Service Models (1999). Relevant guidance • NICE technology appraisal in development. Aripiprazole for the treatment of schizophrenia in people aged 15-17. Expected October 20101. • NICE technology appraisal. The clinical effectiveness and cost effectiveness of newer atypical antipsychotic drugs for schizophrenia. 20022. • NICE clinical guideline. Core interventions in the treatment and management of schizophrenia in primary and secondary care (update). 20093. • NICE clinical guideline. Schizophrenia: core interventions in the treatment and management of schizophrenia in primary and secondary care. 20024. 5 • Clinical Knowledge Summaries. Schizophrenia – Management. 2009 . • American Psychiatric Association. Practice guideline for the treatment of patients with schizophrenia. 20046. 7 • SIGN. Psychosocial Interventions in the Management of Schizophrenia. 1998 . Clinical need and burden of disease Schizophrenia is a psychiatric disorder that alters an individual’s perception, thoughts, affect and behaviour. Acute schizophrenia is marked by characteristic positive symptoms of hallucinations, delusions and behavioural disturbances such as agitation and distress. Following resolution of the acute phase, positive symptoms may diminish or disappear 2 January 2010 leaving negative symptoms which may include: poor self care, reduced motivation, reduced ability to experience pleasure, reduced production of thought, lack of emotional expression, reduced social functioning and, rarely, catatonia. This phase may last many years and is often interrupted by acute exacerbations or relapses3. Schizophrenia is the most common form of psychotic disorder. The National Survey of Psychiatric Morbidity in the UK found a population prevalence of probable psychotic disorder of 5 per 1000 in the age group 16–74 years3. In England, in 2005-06 there were 24,349 finished consultant episodes with a diagnosis of schizophrenia (ICD10 F20) resulting in 20,334 admissions and 1,870,301 bed days8. Mortality among people with schizophrenia is approximately 50% above that of the general population, partly as a result of an increased incidence of suicide (about 10% die by suicide) and violent death, and partly as a result of an increased risk of a wide range of physical health problems3. In 2008 in England and Wales there were 7,519,687 prescription items dispensed in the community for antipsychotic drugs and antipsychotic depot injections with a net ingredient cost of £297,115,4759,10. Existing comparators and treatments Treatment aims are to manage acute episodes, prevent relapse and to improve quality of life, with minimal adverse effects11. Drug treatment for schizophrenia is principally with antipsychotic agents. Current treatment options include12: • Atypical antipsychotic drugs (amisulpride, aripiprazole, clozapine, olanzapine, paliperidone, quetiapine, risperidone and zotepine). • Phenothiazine derivatives (chlorpromazine, levomepromazine, promazine, pericyazine, pipotiazine, fluphenazine, perphenazine and trifluoperazine). • Butyrophenones (haloperidol). • Diphenylbutylpiperidines (pimozide). • Thioxanthenes (flupentixol and zuclopenthixol). • Substituted benzamides (sulpiride). Guidelines recommended that atypical antipsychotic drugs should be considered for the first line treatment of newly diagnosed schizophrenia and for managing an acute schizophrenic episode2. Non-pharmaceutical treatments include: individual psycho-educational interventions, family interventions, cognitive behavioural therapy and assertive community treatment. Efficacy and safety Trial 41022, Hera 022, 41021, Hera 021, 41512, P05784, NCT00151424; asenapine, NCT00156117; asenapine, NCT00156091; phase III; olanzapine or placebo; olanzapine or placebo; extension. phase III. phase III. Sponsor Organon. Organon. Organon. Status Trial complete, Trial complete, Trial complete. unpublished. unpublished. Source of Trial registry13, Trial registry15, Trial registry16, review14. information manufacturer, review14. manufacturer, review14. Location USA, Ukraine and Russia. USA, Russia and Ukraine. Not known. Design Randomised, controlled. Randomised, controlled. Extension trial. 3 January 2010 Participants n=277; adults; acute n=417; adults; acute n=260; completed 41021, and schedule schizophrenia; PANSSa schizophrenia; PANSS NCT00156117. ≥60; PANSS positive score ≥60; PANSS positive Subjects receiving placebo subscale ≥4 in 2 or more subscale ≥4 in 2 or more received asenapine 5mg items; CGI-Sb ≥4; response items; CGI-S ≥4; response twice daily for week 1 then to an antipsychotic other to antipsychotic other than 5mg or 10mg twice daily. than clozapine. clozapine. Randomised to asenapine Randomised to asenapine 5mg or 10mg twice daily, 5mg or 10mg twice daily, olanzapine 10-20mg daily, olanzapine 15mg daily, or or placebo. placebo. Follow-up 6 weeks treatment. 6 weeks treatment. 1 yr. Primary PANSS. PANSS. Long-term safety, extra- outcomes pyramindal symptoms, maintenance of effect, QLSc, Q-LES-Qd, PETiTe. Secondary PANSS subscales, CGI-S, PANSS negative subscale. Neurocognition, cognitive outcomes CGI-If. functioning, weight, ECGs, CDSSg (depression). Key results Mean change from Mean change from Not known. baseline for total PANSS baseline for PANSS total asenapine, olanzapine and score, asenapine 5mg, placebo respectively (p asenapine 10mg, values vs placebo): -9.4 olanzapine 15mg and (p=0.84), -11.5 (p=0.50), placebo respectively: -9.9. -14.5, -13.4, -16.5, -11.1. No statistically significant differences vs placebo. Olanzapine superior to placebo. Adverse ≥1 AE asenapine, ≥1 AE asenapine 5mg, Not known. effects (AEs) olanzapine and placebo asenapine 10mg, respectively: 68.9%, olanzapine and placebo 63.0%, 60.2%. respectively: 71.2%, 73.5%, 71.6%, 70.0%. Trial 41023, Hera 023, 41513, Hera, A7501012, RHEA, NCT00156104; asenapine NCT00156065; phase III; P05770, NCT00150176; vs haloperidol or placebo; extension. asenapine vs placebo; phase III. phase III. Sponsor Organon. Organon. Schering-Plough. Status Trial complete, Trial complete, Trial complete, unpublished. unpublished. unpublished. Source of Trial registry17, Trial registry18, review14. Trial registry19, information manufacturer, review14. manufacturer, review14. Location USA, Canada, Russia, Not known. USA and other countries. India and Romania. Design Randomised, controlled. Extension trial. Randomised, placebo controlled. a PANSS - Positive and Negative Syndrome Scale b CGI-S - Clinical Global Impressions scale - Severity c QLS - Quality of Life Scale d Q-LES-Q - Quality of Life Enjoyment and Satisfaction Questionnaire e PETiT - Personal Evaluation Of Transitions In Treatment f CGI-I - Clinical Global Impressions scale - Improvement g CDSS - Calgary Depression Scale for Schizophrenia 4 January 2010 Participants n=458; adults; acute n=187; completed 041023, n=386; adults; and schedule schizophrenia; PANSS NCT00156104. schizophrenia; ≥1 episode score ≥60; PANSS positive Subjects on placebo in in the previous 3 yrs; ≥1 yr subscale ≥4 in 2 or more study 041023 received continuous antipsychotics; items; CGI-S ≥4; response asenapine 5mg twice daily stable for ≥4 weeks. to antipsychotic other than for week 1 then asenapine Asenapine 5-10mg or clozapine. 5mg or 10mg twice daily. placebo. Randomised to asenapine 5mg, 10mg, haloperidol 4mg or placebo, all twice daily. Follow-up 6 weeks treatment. 1 year treatment. 56 weeks. Primary PANSS. Safety, maintenance of Time to relapse or outcomes effect, QoL, patient impending relapse. functionality. Secondary PANSS negative subscale. Neurocognition and 5 dimensions of outcomes cognitive functioning, schizophrenia, CGI-S, weight, ECGs, CDSS depressive, suicidal (depression). thinking, cognition.
Load more

Recommended publications
  • 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.
    [Show full text]
  • 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,
    [Show full text]
  • 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.
    [Show full text]
  • 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.
    [Show full text]
  • 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
    [Show full text]
  • Antipsychotics
    bmchp.org | 888-566-0008 wellsense.org | 877-957-1300 Pharmacy Policy Antipsychotics Policy Number: 9.503 Version Number: 2.1 Version Effective Date: 9/1/2021 Product Applicability All Plan+ Products Well Sense Health Plan Boston Medical Center HealthNet Plan New Hampshire Medicaid MassHealth - MCO MassHealth - ACO Qualified Health Plans/ConnectorCare/Employer Choice Direct Senior Care Options __________________________________ Note: Disclaimer and audit information is located at the end of this document. Prior Authorization Policy Products Affected: aripiprazole ODT Latuda (lurasidone) aripiprazole Sol Nuplazid (pimavanserin) asenapine maleate Rexulti (brexpiprazole) clozapine ODT Vraylar (cariprazine) risperidone ODT Versacloz (clozapine) Fanapt (iloperidone) Secuado (asenapine) Paliperidone The Plan may authorize coverage of the above products for members meeting the following criteria: Covered All FDA approved indications not otherwise excluded Use All indications supported by established clinical literature for the medical condition and age + Plan refers to Boston Medical Center Health Plan, Inc. and its affiliates and subsidiaries offering health coverage plans to enrolled members. The Plan operates in Massachusetts under the trade name Boston Medical Center HealthNet Plan and in other states under the trade name Well Sense Health Plan. Antipsychotics 1 of 6 Exclusion None Criteria Required Medical Information clozapine ODT, risperidone ODT, aripiprazole ODT, aripiprazole sol, Versacloz 1. A diagnosis of bipolar disorder, schizophrenia, or other psychotic disorder; OR 2. A diagnosis of major depression requiring adjunct therapy ( aripiprazole ODT, aripiprazole sol only); AND 3. Clinical swallowing difficulties (including unwillingness to swallow tablets) Fanapt, palipedione (oral), Latuda, Vraylar 1. A diagnosis of bipolar disorder, schizophrenia, or other psychotic disorder; AND 2. An inadequate response, intolerance or contraindication to a trial of two covered atypical antipsychotics (See Appendix A) Nuplazid 1.
    [Show full text]
  • Medications Approved by the FDA for Bipolar Disorder Medication Brand Name Common Side Effects May Interact With
    Medications Approved by the FDA for Bipolar Disorder Medication Brand Name Common side effects May interact with Aripiprazole Abilify® Insomnia Antidepressants such as Prozac or Paxil Nausea Mood stabilizers such as Equetro or Tegretol Restlessness Tiredness Asenapine Saphris® Sleepiness Antihypertensive medications Dizziness Antidepressants Strange sense of taste Anxiety medications Numbing of the mouth Nausea Increased appetite Feeling tired Weight gain Carbamazepine Equetro™ Dizziness Birth control pills (can make them extended release capsules Drowsiness ineffective) Mood stabilizers such as Lithium, Lamictal, Nausea or Depakote Dry mouth Anticonvulsant medications Blurred vision Anxiety medications Decreased white blood cell count Macrolide antibiotics Can rarely cause severe skin Tricyclic antidepressants rashes Cancer medications HIV/AIDS medications Cytotoxic or immunosuppressive Medications Grapefruit juice Cariprazine Vraylar® Muscle stiffness Antidepressants Indigestion Pain medications Vomiting Anxiety medications Sleepiness Mood stabilizers such as Lithium Restlessness Anticonvulsants such as Lamictal Antipsychotics such as Latuda or Seroquel Divalproex Sodium Depakote® Nausea Aspirin or other blood thinning medications Shaking Mood stabilizers such as Equetro,Tegretol, Weight gain or Lamictal Decrease in blood platelets Barbiturates Rash Cyclosporine (Neoral or Sandimmune) Pancreatitis Liver dysfunction (rare) Polycystic Ovary Syndrome (rare) Fluoxetine + Olanzapine Symbyax® Dizziness MAOI antidepressants Drowsiness Antipsychotics
    [Show full text]
  • 1 Louisiana Medicaid Behavioral Health Medications for Children
    Louisiana Medicaid Behavioral Health Medications for Children Under 6 Years of Age For Medications Not Addressed on the Preferred/Non-Preferred Drug List The Louisiana Uniform Prescription Drug Prior Authorization Form should be utilized to request clinical authorization for all behavioral health medications for children under 6 years of age. Additional Point-of-Sale edits may apply. In addition to the therapeutic classes on the Preferred/Non-Preferred Drug List (PDL/NPDL) that include criteria for use in children under 6 years of age (Stimulants and Related Agents, Antidepressants, Antipsychotics, and Anxiolytics), the following behavioral health medications that are not found on the PDL/NPDL, when prescribed for a behavioral health diagnosis for children under 6 years of age, require authorization: Additional Antidepressants – Amitriptyline, Amitriptyline/Chlordiazepoxide, Amoxapine, Chlorpromazine, Clomipramine , Desipramine, Doxepin, Imipramine, Maprotiline, Nortriptyline, Protriptyline, Trimipramine Additional Antipsychotics – Asenapine Transdermal (Secuado®) Additional Anxiolytic Agents – Chlordiazepoxide/Clidinium, Clonazepam, Lorazepam Injection Mood Stabilizers – Carbamazepine (Equetro®), Lithium All of these agents have Black Box Warnings; see individual prescribing information for details. When a pharmacy claim for carbamazepine (Equetro®) or clonazepam for a child under 6 years of age is submitted with a diagnosis code for seizures, the claim will bypass the behavioral health authorization requirement. Initial and Reauthorization
    [Show full text]
  • Psychotropic Drug Indications
    PSYCHOTROPIC DRUG INDICATIONS (Part 1 of 2) Bipolar Disorder Mixed Generic Brand Form Mania Depression Episodes Maintenance MDD TRD PMDD Schizophrenia Others4 ATYPICAL ANTIPSYCHOTICS aripiprazole — tabs, ODT, oral √ √ √ √1 √ √ soln Abilify tabs √ √ √ √1 √ √ Abilify ext-rel IM inj √ √ Maintena Abilify tabs with √ √ √ √1 √ Mycite sensor aripiprazole Aristada ext-rel IM inj √ lauroxil Aristada ext-rel IM inj √ Initio asenapine Saphris sublingual tabs √ √ √ √ brexpiprazole Rexulti tabs √1 √ cariprazine Vraylar caps √ √ √ √ lurasidone Latuda tabs √ √ olanzapine Zyprexa tabs √ √2 √ √ √2 √ IM inj √ Zyprexa ext-rel IM inj √ Relprevv Zyprexa ODT √ √2 √ √ √2 √ Zydis quetiapine Seroquel tabs √ √ √ √ Seroquel XR ext-rel tabs √ √ √ √ √1 √ risperidone Perseris ext-rel SC inj √ Risperdal tabs, oral soln √ √ √ √ Risperdal ext-rel IM inj √ √ Consta Risperdal ODT √ √ √ √ M-tabs ziprasidone Geodon caps √ √ √1 √ IM inj √ COMBINATION ATYPICAL & SELECTIVE SEROTONIN REUPTAKE INHIBITOR olanzapine + Symbyax caps √ √ fluoxetine MONOAMINE OXIDASE INHIBITORS (MAOIs) phenelzine Nardil tabs √ selegiline EMSAM transdermal √ system tranylcypromine Parnate tabs √ SEROTONIN AND NOREPINEPHRINE REUPTAKE INHIBITORS (SNRIs) desvenlafaxine Khedezla ext-rel tabs √ Pristiq ext-rel tabs √ duloxetine Cymbalta caps √ √ levomilnacipran Fetzima ext-rel caps √ venlafaxine — scored tabs √ Effexor XR ext-rel caps √ √ SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIs) citalopram Celexa scored tabs √ escitalopram Lexapro scored tabs, √ √ oral soln fluoxetine — tabs, oral soln √3 √ √3 √ Prozac
    [Show full text]
  • Medications to Be Avoided Or Used with Caution in Parkinson's Disease
    Medications To Be Avoided Or Used With Caution in Parkinson’s Disease This medication list is not intended to be complete and additional brand names may be found for each medication. Every patient is different and you may need to take one of these medications despite caution against it. Please discuss your particular situation with your physician and do not stop any medication that you are currently taking without first seeking advice from your physician. Most medications should be tapered off and not stopped suddenly. Although you may not be taking these medications at home, one of these medications may be introduced while hospitalized. If a hospitalization is planned, please have your neurologist contact your treating physician in the hospital to advise which medications should be avoided. Medications to be avoided or used with caution in combination with Selegiline HCL (Eldepryl®, Deprenyl®, Zelapar®), Rasagiline (Azilect®) and Safinamide (Xadago®) Medication Type Medication Name Brand Name Narcotics/Analgesics Meperidine Demerol® Tramadol Ultram® Methadone Dolophine® Propoxyphene Darvon® Antidepressants St. John’s Wort Several Brands Muscle Relaxants Cyclobenzaprine Flexeril® Cough Suppressants Dextromethorphan Robitussin® products, other brands — found as an ingredient in various cough and cold medications Decongestants/Stimulants Pseudoephedrine Sudafed® products, other Phenylephrine brands — found as an ingredient Ephedrine in various cold and allergy medications Other medications Linezolid (antibiotic) Zyvox® that inhibit Monoamine oxidase Phenelzine Nardil® Tranylcypromine Parnate® Isocarboxazid Marplan® Note: Additional medications are cautioned against in people taking Monoamine oxidase inhibitors (MAOI), including other opioids (beyond what is mentioned in the chart above), most classes of antidepressants and other stimulants (beyond what is mentioned in the chart above).
    [Show full text]
  • Application of a Pharmacogenetics-Based Precision Medicine Model (5SPM) to Psychotic Patients That Presented Poor Response to Neuroleptic Therapy
    Journal of Personalized Medicine Article Application of a Pharmacogenetics-Based Precision Medicine Model (5SPM) to Psychotic Patients That Presented Poor Response to Neuroleptic Therapy Lorena Carrascal-Laso 1 , Manuel Ángel Franco-Martín 1,* , María Belén García-Berrocal 2 , Elena Marcos-Vadillo 2, Santiago Sánchez-Iglesias 3, Carolina Lorenzo 3, Almudena Sánchez-Martín 4, Ignacio Ramos-Gallego 5, M Jesús García-Salgado 2 and María Isidoro-García 2,6 1 Servicio de Psiquiatría, Hospital Provincial de Zamora, IBSAL, 49071 Zamora, Spain; [email protected] 2 Farmacogenética y Medicina de Precisión, Servicio de Bioquímica, Hospital Universitario de Salamanca, IBSAL, 37007 Salamanca, Spain; [email protected] (M.B.G.-B.); [email protected] (E.M.-V.); [email protected] (M.J.G.-S.); [email protected] (M.I.-G.) 3 Servicio de Psiquiatría, Hospital Universitario de Salamanca, IBSAL, 37007 Salamanca, Spain; [email protected] (S.S.-I.); [email protected] (C.L.) 4 Pharmacogenetics Unit, Pharmacy Department, University Hospital Virgen de las Nieves, UGC Provincial de Farmacia de Granada, Avda, Fuerzas Armadas, 18014 Granada, Spain; [email protected] 5 Departamento de Fisiología y Farmacología, Universidad de Salamanca, 37007 Salamanca, Spain; [email protected] 6 Departamento de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain * Correspondence: [email protected] Received: 4 November 2020; Accepted: 15 December 2020; Published: 18 December 2020 Abstract: Antipsychotics are the keystone of the treatment of severe and prolonged mental disorders. However, there are many risks associated with these drugs and not all patients undergo full therapeutic profit from them. The application of the 5 Step Precision Medicine model(5SPM), based on the analysis of the pharmacogenetic profile of each patient, could be a helpful tool to solve many of the problematics traditionally associated with the neuroleptic treatment.
    [Show full text]
  • Currently Prescribed Psychotropic Medications
    CURRENTLY PRESCRIBED PSYCHOTROPIC MEDICATIONS Schizophrenia Depression Anxiety Disorders 1st generation antipsychotics: Tricyclics: Atarax (hydroxyzine) Haldol (haloperidol), *Anafranil (clomipramine) Ativan (lorazepam) Haldol Decanoate Asendin (amoxapine) BuSpar (buspirone) Loxitane (loxapine) Elavil (amitriptyline) *Inderal (propranolol) Mellaril (thioridazine) Norpramin (desipramine) Keppra (levetiracetam) Navane (thiothixene) Pamelor (nortriptyline) *Klonopin (clonazepam) Prolixin (fluphenazine), Prolixin Sinequan (doxepin) Librium (chlordiazepoxide) Decanoate Spravato (esketamine) Serax (oxazepam) Stelazine (trifluoperazine) Surmontil (trimipramine) Thorazine (chlorpromazine) *Tenormin (atenolol) Tofranil (imipramine) MEDICATIONS PSYCHOTROPIC PRESCRIBED CURRENTLY Trilafon (perphenazine) Tranxene (clorazepate) Vivactil (protriptyline) Valium (diazepam) 2nd generation antipsychotics: Zulresso (brexanolone) Vistaril (hydroxyzine) Abilify (aripiprazole) Aristada (aripiprazole) SSRIs: Xanax (alprazolam) Caplyta (lumateperone) Celexa (citalopram) *Antidepressants, especially SSRIs, are also used in the treatment of anxiety. Clozaril (clozapine) Lexapro (escitalopram) Fanapt (iloperidone) *Luvox (fluvoxamine) Geodon (ziprasidone) Paxil (paroxetine) Stimulants (used in the treatment of ADD/ADHD) Invega (paliperidone) Prozac (fluoxetine) Invega Sustenna Zoloft (sertraline) Adderall (amphetamine and Perseris (Risperidone injectable) dextroamphetamine) Latuda (lurasidone) MAOIs: Azstarys(dexmethylphenidate Rexulti (brexpiprazole) Emsam (selegiline)
    [Show full text]