Therapeutic Advances in Psychopharmacology

No abstract text is available yet for this article.

BACKGROUND: The benefit of generalist pharmacists working within primary care networks (PCNs) and with general practitioners (GPs) is established. We wished to evaluate the contributions and potential benefits of a specialist mental health care prescribing pharmacist within PCNs. METHOD: We prospectively collected data, on clinical and demographic characteristics, referral sources, interventions, outcomes (objective and subjective), and patient feedback, from 466 completed patients, in one PCN by one specialist mental health pharmacist (working 0...

No abstract text is available yet for this article.

BACKGROUND: Reducing the dose of psychosis drugs in a gradual hyperbolic manner may minimise withdrawal effects and risk of relapse. There is presently limited guidance on tapering decanoate-based long-acting injectable dopamine antagonists (LIDAs). OBJECTIVES: We aimed to apply hyperbolic principles of tapering to the decanoate-based LIDAs flupentixol, zuclopenthixol and haloperidol to develop withdrawal regimens. DESIGN: We used in silico methodology to predict plasma drug levels and D2 occupancy for different LIDA regimens...

[This corrects the article DOI: 10.1177/20451253241243242.].

BACKGROUND: Psychedelics are receiving growing interest among clinical researchers for their effects on mood and cognition. Psilocybin is one of the most widely studied classic psychedelics which has shown good safety and clinical benefit for major depression and substance use disorders. Athletes frequently sustain concussions and often experience myriad symptoms, including cognitive and mood issues, which can persist for weeks or months in 10%-30% of athletes. Psilocybin may be a potential symptom management option for athletes with persisting concussion symptoms...

Effective management of schizophrenia (SZ) requires long-term treatment with antipsychotics (APs) to prevent clinical relapse, attain remission and improve patients' personal and social functioning, and quality of life. Although APs remain the cornerstone treatment for patients with SZ, despite their potential benefits, long-acting injectable APs (LAI-APs) remain underused, most notably in women with SZ. The efficacy and tolerability of APs differ significantly between men and women, and some of these differences are more noticeable depending on the patient's age and the stage of the disorder...

Gastric malabsorptive conditions may prevent patients from deriving benefit from orally administered medications intended for enteric absorption. While malabsorption is an increasingly common issue, current data on alternative oral options for agitation in these patients are very sparse. Sublingual (SL) asenapine is absorbed transmucosally, bypassing gut absorption, making it a viable consideration. We report on three patients, one with short bowel syndrome, one with viral gastritis, and one with aortic dissection who were trialed on SL asenapine for agitation after failing alternative antipsychotics...

BACKGROUND: Long-acting injectable antipsychotics (LAIs) have advantages over oral antipsychotics (OAPs) in preventing relapse and hospitalization in chronically ill patients with schizophrenia-spectrum disorders (SSDs), but evidence in patients with first-episode/recent-onset, that is, early-phase-SSDs is less clear. OBJECTIVES: To assess the relative medium- and long-term efficacy and safety of LAIs versus OAPs in the maintenance treatment of patients with early-phase SSDs...

BACKGROUND: Antipsychotic medications are associated with weight gain and metabolic derangement. However, comprehensive evidence for the efficacy of co-commenced pharmacological treatments to mitigate initial weight gain is limited. Metformin has been shown to be effective in reducing weight among people on antipsychotic medications who are already overweight, but the potential benefits of metformin co-commencement in mitigating antipsychotic-induced weight gain has not been systematically reviewed...

Tricyclic antidepressants (TCAs) remain widely prescribed for depression and many other conditions. There may be important differences between individual TCA in regard to their overdose toxicity and their cardiac toxicity in clinical use. We conducted a systematic review to compare the toxicity of individual TCA in overdose and the risk of serious adverse cardiac events occurring with therapeutic doses. We used the fatal toxicity index (FTI) and case fatality ratio as markers of fatality in overdose, and hazard ratios or odds ratios for the risk of cardiovascular adverse events during normal clinical use...

This case report examines the possible correlation between the clozapine/norclozapine ratio and the occurrence of constipation and paralytic ileus. We present the case of a 42-year-old patient diagnosed with schizoaffective disorder undergoing clozapine therapy. Despite intensive treatment with clozapine, haloperidol, valproic acid and biweekly electroconvulsive therapy sessions for over a year, florid psychotic symptoms and fluctuating mood swings persisted. Therefore, valproic acid was replaced by carbamazepine, a potent inducer of several CYP450-enzymes...

[This corrects the article DOI: 10.1177/20451253231165169.].

Clozapine, renowned for its efficacy in treatment-resistant schizophrenia, is associated with rare yet potentially severe side effects, including hematological disorders, myocarditis, seizures and gastrointestinal obstruction. Dermatological adverse effects, though less serious, can profoundly impact patients' quality of life. We present the first reported case of cholinergic urticaria induced by clozapine, in a 25-year-old male with treatment-resistant schizophrenia. Four months into clozapine therapy, the patient developed intensely pruritic erythematous lesions triggered by sweating, significantly impairing his daily activities...

Cognitive dysfunctions are one of the key symptoms of schizophrenia (SZ) and major depressive disorder (MDD), which exist not only during the onset of diseases but also before the onset, even after the remission of psychiatric symptoms. With the development of neuroimaging techniques, these non-invasive approaches provide valuable insights into the underlying pathogenesis of psychiatric disorders and information of cognitive remediation interventions. This review synthesizes existing neuroimaging studies to examine domains of cognitive impairment, particularly processing speed, memory, attention, and executive function in SZ and MDD patients...

No abstract text is available yet for this article.

BACKGROUND: Coronavirus disease 2019 pandemic pointed out significant mental symptoms of frontline healthcare workers (HCWs). OBJECTIVE: We aimed to estimate the prevalence and comorbidity of post-traumatic stress symptoms (PTSS), depression and anxiety symptoms in HCWs from Fangcang shelter hospitals during the pandemic. DESIGN: Demographic information, post-traumatic stress disorder checklist for DSM-5 (PCL-5), Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Questionnaire (GAD-7) were obtained online based on stratified random sampling design during April 2022, with 284 eligible responses...

BACKGROUND: The effectiveness of long-acting injectable (LAI) antipsychotics in preventing relapses of first-episode psychosis is currently debated. OBJECTIVES: The study aimed to investigate the number of psychiatric hospitalizations comparing the LAI cohort versus the oral cohort during different phases of the illness, pre-LAI treatment, during LAI treatment, and after LAI treatment. DESIGN: A naturalistic study was conducted on two independent cohorts of early psychosis patients receiving treatment from a specific early intervention service...

BACKGROUND: Cognitive models of post-traumatic stress disorder (PTSD) highlighted the effect of maladaptive cognitive processing in the development and maintenance of PTSD. PTSD is related to attentional bias (AB) toward threatening stimuli and greater attentional bias variability (ABV). Attentional bias modification (ABM) and attention control training (ACT) have demonstrated the effect of improving PTSD, but the results of randomized controlled trials (RCTs) are controversial. OBJECTIVES: The current study aimed to evaluate the extent of evidence supporting the efficacy of ABM in the treatment of PTSD...

BACKGROUND: Intravenous (IV) ketamine is a rapid acting antidepressant used primarily for treatment-resistant depression (TRD). It has been suggested that IV ketamine's rapid antidepressant effects may be partially mediated via improved sleep and changes to the circadian rhythm. OBJECTIVES: This study explores IV ketamine's association with changes in patient-reported sleep quality and circadian rhythm in an adult population with TRD. METHODS: Adult patients (18-64 years) with TRD scheduled for IV ketamine treatment were recruited to complete patient rated outcomes measures on sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and circadian rhythm using the Morningness-Eveningness Questionnaire (MEQ)...