Antipsychotics

Source: www.ncbi.nlm.nih.gov --- 5 days ago
Related Articles Exposure to Antipsychotics and risk of stroke: self controlled case series study. BMJ. 2008;337:a1227 Authors: Douglas IJ, Smeeth L OBJECTIVES: To investigate the association between use of typical and atypical antipsychotic drugs and incidence of stroke in patients with and without dementia. DESIGN: Self controlled case series. SETTING: UK based electronic primary care records in the general practice research database (GPRD). PARTICIPANTS: All patients registered in the database with a recorded incident stroke and at least one prescription for any antipsychotic drug before the end of 2002: 6790 eligible participants were identified and included in the final analysis. MAIN OUTCOME MEASURES: Rate ratio for stroke in periods of time exposed to Antipsychotics compared with unexposed periods. RESULTS: Use of any antipsychotic drug was associated with a rate ratio for stroke of 1.73 (95% confidence interval 1.60 to 1.87): 1.69 (1.55 to 1.84) for typical Antipsychotics and 2.32 (1.73 to 3.10) for atypical Antipsychotics. In patients receiving any antipsychotic drug, the rate ratios were 3.50 (2.97 to 4.12) for those with dementia and 1.41 (1.29 to 1.55) for those without dementia. CONCLUSIONS: All Antipsychotics are associated with an increased risk of stroke, and the risk might be higher in patients receiving atypical Antipsychotics than those receiving typical Antipsychotics. People with dementia seem to be at a higher risk ...

Source: www.ncbi.nlm.nih.gov --- 33 days ago
Related Articles World Psychiatric Association Pharmacopsychiatry Section statement on comparative effectiveness of Antipsychotics in the treatment of schizophrenia. Schizophr Res. 2008 Mar;100(1-3):20-38 Authors: Tandon R, Belmaker RH, Gattaz WF, Lopez-Ibor JJ, Okasha A, Singh B, Stein DJ, Olie JP, Fleischhacker WW, Moeller HJ, Data from two major government-funded studies of comparative antipsychotic effectiveness in schizophrenia contradict the widely prevalent belief that the newer second-generation medications are vastly superior to the older first-generation drugs. This has caused uncertainty among patients, clinicians and policy-makers about the relative utility of first- and second- generation antipsychotic agents in its treatment. To reduce confusion and provide a contextual understanding of the new data, the World Psychiatry Association Section on Pharmacopsychiatry comprehensively reviewed the literature on the comparative effectiveness of different antipsychotic treatments for schizophrenia and developed this update. Utilizing data from the approximately 1,600 randomized controlled trials of antipsychotic treatment in schizophrenia, we applied the two indirect and one direct method to comparing the effectiveness of 62 currently-available antipsychotic agents. The subclasses of 51 first-generation and 11 second-generation Antipsychotics were both found to be very heterogeneous, with substantial differences in side-effect pro ...

Source: www.ncbi.nlm.nih.gov --- 30 days ago
Related Articles Effectiveness of second generation Antipsychotics: a systematic review of randomized trials. BMC Psychiatry. 2008;8:31 Authors: Johnsen E, Jørgensen HA BACKGROUND: Systematic reviews based on efficacy trials are inconclusive about which second generation antipsychotic drug (SGA) should be preferred in normal clinical practice, and studies with longer duration and more pragmatic designs are called for. Effectiveness studies, also known as naturalistic, pragmatic, practical or real life studies, adhere to these principles as they aim to mimic daily clinical practice and have longer follow-up. OBJECTIVE: To review the head-to-head effectiveness of SGAs in the domains of global outcomes, symptoms of disease, and tolerability. METHODS: Searches were made in Embase, PubMED, and the Cochrane central register of controlled trials for effectiveness studies published from 1980 to 2008, week 1. Different combinations of the keywords antipsychotic*, neuroleptic* AND open, pragmatic, practical, naturalistic, real life, effectiveness, side effect*, unwanted effect*, tolera* AND compar* AND random* were used. RESULTS: Sixteen different reports of randomized head-to-head comparisons of SGA effectiveness were located. There were differences regarding sample sizes, inclusion criteria and follow-up periods, as well as sources of financial sponsorship. In acute-phase and first-episode patients no differences between the SGAs were disclosed ...

Source: www.ncbi.nlm.nih.gov --- 28 days ago
Related Articles A roadmap to key pharmacologic principles in using Antipsychotics in the treatment of bipolar disorder. J Clin Psychiatry. 2008 Jul;69(7):1176-83 Authors: Perlis RH PMID: 18687017 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 34 days ago
Related Articles [Brain in the core of metabolic regulations: disorders in schizophrenic patients treated with atypical Antipsychotics] Rev Med Liege. 2008 May-Jun;63(5-6):417-23 Authors: Hanssens L, Scheen AJ, van Winkel R, Van Eyck D, Reginster JY, De Hert M Schizophrenia is associated with an increased risk of metabolic disorders such as diabetes, dyslipidaemia and the metabolic syndrome. The prevalence of type 2 diabetes in schizophrenic patients is at least twice that of the general population. Around 40 percent of patients meet criteria for the metabolic syndrome. Recently there is a growing concern on the metabolic side effects of treatment with second generation Antipsychotics. According to various studies, including a prospective study performed in Flanders, treatment with clozapine and olanzapine has the highest metabolic risk, followed by quetiapine and risperidone. Amisulpride, ziprasidone and aripiprazole appear to have a low metabolic risk. Appropriate care, taking into account the possible improvement of the metabolic risks factors, is important to reduce morbidity and mortality in schizophrenic patients treated with antipsychotic medications. PMID: 18669214 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 35 days ago
Related Articles Are all Antipsychotics equal? Lancet. 2008 Jul 19;372(9634):201-2; author reply 202 Authors: Volavka J PMID: 18640446 [PubMed - indexed for MEDLINE] ...

Source: www.ncbi.nlm.nih.gov --- 30 days ago
Related Articles Excess of transmission of the G allele of the -1438A/G polymorphism of the 5-HT2A receptor gene in patients with schizophrenia responsive to Antipsychotics. BMC Psychiatry. 2008;8:40 Authors: Benmessaoud D, Hamdani N, Boni C, Ramoz N, Hamon M, Kacha F, Gorwood P BACKGROUND: The -1438A/G polymorphism of the 5-HT2A gene has been found to be associated with clinical response to clozapine and other second generation Antipsychotics. Testing the impact of this marker on response to first generation Antipsychotics (which have a lower affinity for the 5-HT2A receptor) provides the opportunity to help disentangling the two different roles that this polymorphism might have. A psychopharmacogenetic role should be detected only for Antipsychotics with high affinity to the 5-HT2A receptor (therefore to second generation Antipsychotics). An alternative role would imply tagging a subgroup of patients responsive to any antipsychotic, whatever their affinity, meaning that the association is more depending on non pharmacological charaterictics, such as clinical specificities. METHODS: A family-based sample of 100 Algerian patients with schizophrenia (according to DSM-IV criteria) and their 200 biological parents was recruited, in order to avoid stratification biases. Patients were all treated, or have been treated, by conventional Antipsychotics (mainly haloperidol) for at least four weeks, at appropriate dosage. May and Dencker scale wa ...

Source: www.ncbi.nlm.nih.gov --- 21 days ago
Differential Effects of Various Typical and Atypical Antipsychotics on Plasma Glucose and Insulin Levels in the Mouse: Evidence for the Involvement of Sympathetic Regulation. Schizophr Bull. 2008 Aug 14; Authors: Savoy YE, Ashton MA, Miller MW, Nedza FM, Spracklin DK, Hawthorn MH, Rollema H, Matos FF, Hajos-Korcsok E Atypical antipsychotic treatment has been associated with serious metabolic adverse events, such as glucose dysregulation and development of type 2 diabetes. As part of our studies on possible underlying mechanisms, we investigated the acute effects of various typical and atypical Antipsychotics on plasma glucose and insulin in FVB/N mice, a strain that showed a more pronounced hyperglycemic response to clozapine than C57BL/6 and CD-1 mice. Acute administration of high doses of clozapine, olanzapine, quetiapine, perphenazine, or chlorpromazine significantly increased plasma glucose by 100%-140% above basal levels without significant effects on insulin levels. In contrast, risperidone reduced plasma glucose (-30%) and markedly enhanced plasma insulin levels. Doses of ziprasidone that gave 50-fold higher free plasma concentrations than therapeutic plasma levels, as well as high doses of aripiprazole and haloperidol, did not significantly alter either glucose or insulin levels. Clozapine- and olanzapine-induced hyperglycemia occurred at free plasma concentrations that were within, or one order of magnitude above, the range of ...

Source: www.ncbi.nlm.nih.gov --- 24 days ago
Related Articles Caution is still needed when prescribing atypical Antipsychotics. Br J Hosp Med (Lond). 2008 May;69(5):299 Authors: Carey S PMID: 18557562 [PubMed - indexed for MEDLINE] ...

Source: www.ncbi.nlm.nih.gov --- 20 days ago
Antipsychotics associated with pulmonary embolism in a Swedish medicolegal autopsy series. Int Clin Psychopharmacol. 2008 Sep;23(5):263-268 Authors: Jönsson AK, Brudin L, Ahlner J, Hedenmalm K, Eriksson A, Hägg S To determine the association between fatal pulmonary embolism and use of antipsychotic drugs in a Swedish medicolegal autopsy series. Persons aged 18-65 years and subjected to a medicolegal autopsy in 1992-2005 were selected. On the basis of external cause of death, determined by the forensic pathologist, unnatural deaths (including fatal intoxications) were excluded and participants in whom pulmonary embolism was the cause of death were identified. Use of Antipsychotics was based on the results of the postmortem analyses and categorized as use of high-potency first-generation Antipsychotics, low-potency first-generation Antipsychotics, second-generation Antipsychotics or no use of Antipsychotics. Logistic regression analyses were performed. Use of Antipsychotics was verified in 538 of the 14 439 included participants. Pulmonary embolism was recorded as the cause of death in 279 participants and 33 of these used Antipsychotics. Use of low-potency first-generation Antipsychotics and second-generation Antipsychotics was significantly associated with fatal pulmonary embolism (adjusted odds ratio: 2.39; 95% confidence interval: 1.46-3.92 and 6.91; 95% confidence interval: 3.95-12.10, respectively). Out of 26 participants classifi ...

Source: www.medicalnewstoday.com --- 4 days ago
Background Many of the psychiatric disorders observed in adults have their onset in childhood or adolescence. In fact some studies show that at least 20% of children and adolescents will fulfil a diagnostic criterion for a mental disorder before reaching adulthood. The presence of a major mental illness is certainly no less serious in children than in adults - in fact, childhood onset of several psychiatric disorders predicts a worse illness course. ...

Source: www.medicalnewstoday.com --- 4 days ago
This comprehensive study highlights the detrimental affect all types of Antipsychotics have on people with dementia. It confirms previous research that these drugs vastly increase risk of stroke and death. Care home staff need specialist dementia training to effectively care for people with dementia. Alzheimer's Society research shows that specialist training could reduce antipsychotic use by 50% and save the UK £35 million a year, if it was mandatory. ...

Source: www.sciencedaily.com --- 3 days ago
New research illuminates the benefits and risks of antipsychotic medication in children and its impact on individual well-being, social, educational and/or vocational functioning, and disease burden. Scientists have pointed out the challenges that clinicians encounter in treating children and adolescents with psychiatric disorders, and discuss the requirements for starting antipsychotic treatment in clinical practice. ...

Source: www.medicalnewstoday.com --- 7 days ago
Researchers in the UK have found that all drugs used in psychosis treatment are associated with an increased risk of stroke. The findings are published on bmj.com, and include evidence that people who both suffer from dementia and use Antipsychotics are at double the risk of stroke compared to those without dementia. ...

Source: www.library.gsu.edu --- 1 day ago
This NIMH-funded research study (Journal of Child and Adolescent Psychopharmacology, June 2008) indicates that the atypical antipsychotic medication risperidone (Risperdal) does not negatively affect cognitive skills of children with autism, and may lead to improvements. ...

Source: www.library.gsu.edu --- 26 days ago
This summary of an NIMH research study reports that some atypical Antipsychotics may be more likely than others to cause metabolic and cardiovascular side effects, according to recent analyses using data from the NIMH-funded Clinical Antipsychotic Trials of Intervention Effectiveness (CATE). The two studies were published in the April and August issues of Schizophrenia Research. ...

Source: medical.bizcommunity.com --- 5 days ago
All drugs used in the treatment of psychosis appear to increase the risk of stroke. Read full story... | Send to a friend ...

Source: www.nhs.uk --- 8 days ago
“Antipsychotic drug ‘stroke risk’” is the headline on the BBC News website. A study has found that all forms of Antipsychotics boost the risk of stroke in all patients. It reports that research in 2002 raised concerns about the harmful effects of atypical Antipsychotics (a newer generation of antipsychotic drug) in people with dementia; since then drug watchdogs have recommended they not be used in this patient group. Over time, it has been suggested that the studies which demonstrated this link may have been affected by confounders (that is, that other differences between patients, rather than the drugs, explained the results). This study confirms that this is unlikely to be the case, and supports the recommendation that atypical Antipsychotics should not be used by people with dementia. Importantly, this study alone cannot conclude that Antipsychotics increase the absolute risk of stroke compared with not taking Antipsychotics (as some news reports imply), because it only looked at those people who ended up having a stroke. The study suggests that patients who do end up having a stroke are more likely to have it while taking Antipsychotics than when they are not. Based on the fact that people with dementia are more likely to have a stroke than people without dementia, and in light of previous studies, the researchers conclude that Antipsychotics, and in particular atypical Antipsychotics, should if possible be avoided in patient ...

Source: www.medpagetoday.com --- 8 days ago
LONDON (MedPage Today) -- Elderly patients taking antipsychotic drugs of any kind are at an increased risk for ischemic stroke, and the greatest danger faces those with dementia, researchers here said. ...

Source: www.pharmalot.com --- 3 days ago
Earlier this year, we noted that New Jersey’s Medicaid program spent more than $73 million on several antipsychotic meds for children less than 18 years old between 2000 and 2007, according to state records, even though the drugs weren’t approved by the FDA for treating kids. And a state official acknowledged the drugs may have [...] ...