جستجوی مقالات مرتبط با کلیدواژه « antipsychotics » در نشریات گروه « پزشکی »

Assessment of the Quality of Life (QOL) is increasingly performed as an efficient method to assess the quality of care provided for patients with schizophrenia. Also, the QOL assessment performed by patients themselves is more affected by the symptoms of schizophrenia. Therefore, a mental health professional evaluation may provide more objective information. This study was undertaken to objectively assess QOL in a group of remitted patients with schizophrenia in Iran by using Quality of Life Scale (QLS).

This descriptive cross-sectional study was performed on 85 remitted patients with schizophrenia consecutively referred to Roozbeh Hospital. The mean age of the participants was 37.81±9.92 years, 54 (63.53%) were male, 16 (18.8%) were married, and 19 (22.4%) were employed. The Quality of Life Scale (QLS) was used to collect data through face-to-face interviews.

The total score of QLS for patients is 2.95±0.93. Among subscales, the interpersonal relations scores (2.44±1.10) and intrapsychic foundations scores (2.90±1.07) were lower than the other domains scores. The QLS score was higher in patients with an associate degree or higher level of education (p-value<0.01) and those living with family members (p-value<0.01). The overall employment rate was low among the patients. There was no significant relationship between current doses of various medications and any QLS domain scores; however, a significant inverse relationship was between the current doses of first- and second-generation antipsychotics and the instrumental role domain score.

The findings of this study showed that the scores of different domains of QLS were low in the remitted patients with schizophrenia. The impact of different antipsychotic treatments and their side effects on the QOL should be addressed in future studies.

Metabolic syndrome is a potential side effect of atypical antipsychotics which are the current standard treatment for schizophrenia. Therefore, we aimed to examine the effect of barberry root (Berberis vulgaris) on the prevention of metabolic syndrome caused by atypical antipsychotic drugs in patients with schizophrenia.

Our research was a three-blind randomized clinical trial. The participants included all patients who were diagnosed with schizophrenia through the SCID-5 questionnaire and based on the DSM-5-TR criteria by two psychiatric experts. These patients were randomly divided into intervention and placebo groups. During a three-month treatment period, the intervention group received three 500 mg capsules of barberry root extract daily, whereas the placebo group received the same capsules containing 500 mg of starch powder. Metabolic syndrome variables including fasting blood glucose, serum lipids (triglyceride and cholesterol), blood pressure, weight and waist circumference were measured before and after the treatment as outcome measure. Chi-square and t-tests were used for data analysis using SPSS-22 software.

At the beginning of the study, there was no significant difference between the intervention group (n = 41) and the placebo group (n = 47) in terms of demographic factors, and pre-treatment assessments including weight, waist size, fasting blood HDL, fasting blood triglycerides and systolic and diastolic blood pressure and fasting blood glucose (P > 0.05). Within group analysis showed that some metabolic factors significantly increased in both groups after the treatment (P < 0.05). Indeed, in both groups, metabolic syndrome measures worsened after the three-month treatment period. The parameters of weight and waist size were significantly higher in the intervention group than the placebo group after treatment (P < 0.05).

Barberry root extract was not able to control the Effects of antipsychotic drugs on metabolic syndrome in schizophrenia.

Present a case of zuclopenthixol associated priapism, literature review and focus on the stuttering priapism entity as a potential serious complication as well as providing information about possible preventive treatments.

Case report: 

A 44 year-old male patient with history of cocaine abuse with associated priapism presents with acute painful erection after starting zuclopenthixol for treatment of a psychotic episode. This episode was later followed by many other similar episodes defined as stuttering priapism.

Acute ischemic priapism is a potential serious side effect of antipsychotics that physicians especially psychiatrists needs to be aware of especially if the patient has previous episodes in order to prevent reoccurrence.

We analyzed prescribing patterns of antipsychotics for children and adolescent affiliated with a Danish Child and Adolescent Mental Health Center) with respect to age, sex, medicine, diagnoses, off‑label status, and time.

We included all patients below 19 years of age prescribed antipsychotics during 2007–2008 and as of November 1, 2014. Prescription data included all antipsychotic prescriptions and prescriptions of concomitant psychotropic medications. We defined an antipsychotic user as a patient receiving at least one prescription during the study period, irrespective of any previous history of antipsychotic use. We defined off‑label prescribing as prescriptions outside the licensed age group and approved indication.

We analyzed 404 antipsychotic prescriptions that were located for 150 patients. The patients were between 7 and 18 years of age. Two‑thirds of the prescriptions were for girls and two‑thirds of prescriptions for olanzapine and quetiapine. Totally, 92% of all prescribed antipsychotics were used off‑label. For typical antipsychotics, this share was 96% and for atypical antipsychotics 90%. As of November 1, 2014, the total share of off‑label antipsychotic prescriptions was 96%, and 63% of these were for medications prescribed outside the approved age group, and 26% for nonlicensed indication(s).

This study demonstrated a high level of off‑label prescribing over time with respect to age and indication. The prescribing patterns underpin the need for further economic incentives for pharmaceutical companies to register pediatric indications, particular for off‑patent products.

 Diplopia, or double vision, is a common ophthalmologic complaint with many underlying causes, ocular and neurological. Aripiprazole has been reported to have fewer adverse effects and better efficacy than other atypical antipsychotics. Although ocular side effects of aripiprazole are not remarkable, two cases of diplopia associated with aripiprazole have been reported in the literature.

Herein, we report the third case of diplopia, after the aripiprazole prescription in a woman with depressive disorder.

A 37-year-old woman was brought to our clinic with symptoms of sleep loss, displeasure, auditory hallucination, and pessimistic thoughts. After a clinical interview, the patient was diagnosed with depression with psychotic features according to the Diagnostic and Statistical Manual (DSM-V) of mental disorders. She underwent treatment with 15 mg/d aripiprazole and 20 mg/d fluoxetine. Her symptoms reduced after three months as indicated by the visual analog scale. However, the patient returned to the clinic and complained of double vision. Neither neurological nor ophthalmological problems were observed following examinations by specialists. When the dose of the drug decreased and eventually discontinued, diplopia disappeared over 24 hours.

Since the patient had no history of diplopia and two cases of diplopia associated with aripiprazole were previously reported in the literature, we expected that the diplopia was related to the recently prescribed aripiprazole treatment. Physicians should be aware of the possible risk of diplopia-induced by aripiprazole and recommend patients discontinuing the drug immediately if complications have occurred.

Antipsychotics (APs) can induce pathological blood clotting. Deep Vein Thrombosis (DVT) is a common type of Venous Thromboembolism (VTE) and a significant cause of morbidity and mortality worldwide. First or second generation APs have been specifically correlated with an increased risk of thromboembolism.

We report a case of a bipolar female patient who developed DVT following an increase in her daily dose of APs (olanzapine and chlorpromazine).

Physicians in other medical fields, including internal medicine and surgery, should be trained about the complication of DVT induced by APs.

The effect of metformin on weight changes and some metabolic parameters in patients with schizophrenia and schizoaffective disorder was investigated in this study.

As a randomized double-blind controlled clinical trial, this study was performed from 2018 to 2019. A total of 66 obese patients (BMI≥27) with schizophrenia and schizoaffective disorder, hospitalized in the departments of Razi Psychiatric Hospital, entered the study; then, they were randomly divided into intervention and control groups after completing the informed consent form. The patients received metformin or placebo for 12 weeks. The dose of metformin was gradually increased and in case of a patient’s tolerance, was prescribed up to 500 mg twice daily. During the study, all patients received their previous therapies. The variables included BMI, weight, waist circumference, lipid profile, and fasting blood glucose, which were studied at the beginning of the study and at weeks 4, 8, and, 12. The data were analyzed, using a post hoc test by SPSS software.

The results showed a significant decrease in weight (3.5 kg) and BMI (1.30) at the end of the week 12, and there was a significant reduction in waist circumference (5.9 cm) at the end of the week 8 compared to the placebo group (P<0.05). Moreover, metformin had no significant effect on fasting blood glucose and lipid profile in comparison with the placebo group.

Based on the findings of this study, by reducing the weight, waist circumference, and BMI, metformin can have a significant role in decreasing the complications of obesity and metabolic disorders in patients with schizophrenia and schizoaffective disorder. Therefore, given that the complications of metformin are low and transient, it can be recommended as a safe and tolerable drug in obese patients with schizophrenia and schizoaffective disorder.

Coronavirus disease 2019 (COVID-19) has become a pandemic with 1771514 cases identified in the world and 70029 cases in Iran until April 12, 2020. The co-prescription of psychotropics with COVID-19 medication is not uncommon. Healthcare providers should be familiar with many Potential Drug-Drug Interactions (DDIs) between COVID-19 therapeutic agents and psychotropic drugs based on cytochrome P450 metabolism. This review comprehensively summarizes the current literature on DDIs between antiretroviral drugs and chloroquine/hydroxychloroquine, and psychotropics, including antidepressants, antipsychotics, mood stabilizers, and anxiolytics.

Medical databases, including Google Scholar, PubMed, Web of Science, and Scopus were searched to identify studies in English with keywords related to psychiatric disorders, medications used in the treatment of psychiatric disorders and COVID-19 medications.

There is a great potential for DDIs between psychiatric and COVID-19 medications ranging from interactions that are not clinically apparent (minor) to those that produce life-threatening adverse drug reactions, or loss of treatment efficacy. The majority of interactions are pharmacokinetic interactions via the cytochrome P450 enzyme system.

DDIs are a major concern in the comorbidity of psychiatric disorders and COVID-19 infection resulting in the alteration of expected therapeutic outcomes. The risk of toxicity or lack of efficacy may occur due to a higher or lower plasma concentration of medications. However, psychiatric medication can be safely used in combination with COVID-19 pharmacotherapy with either a wise selection of medication with the least possibility of interaction or careful patient monitoring and management.