Adjunctive memantine in clozapine-treated refractory schizophrenia: A one-year extension study

2016 ◽  
Vol 33 (S1) ◽  
pp. S108-S109
Author(s):  
S. Veerman ◽  
P. Schulte ◽  
J.B. Deijen ◽  
L. de Haan
Keyword(s):  
Beneficial Effect ◽  
Verbal Memory ◽  
Psychosocial Functioning ◽  
Visual Memory ◽  
Negative Symptoms ◽  
Rating Scale ◽  
Extension Study ◽  
Long Term Effects ◽  
Positive Effects ◽  
One Year

IntroductionIn a recent 26-week placebo-controlled, crossover trial (n = 52) we found significant positive effects on verbal and visual memory, and negative symptoms in clozapine-treated patients with refractory schizophrenia.ObjectivesIn this 1-year extension study, we report the long-term effects and tolerability of memantine add-on therapy to clozapine.AimsTo evaluate the persistence of improvements in cognitive functioning and symptoms of memantine add-on therapy to clozapine in schizophrenia.MethodsCompleters of the first trial who experienced a beneficial effect of memantine after 12 weeks continued memantine for one year. Primary endpoints were change from baseline to 26 weeks treatment and 26 weeks to 52 weeks treatment on memory and executive function using the Cambridge Neuropsychological Test Automated Battery (CANTAB), Positive and Negative Syndrome Scale (PANSS), and Clinical Global Impression Severity Scale (CGI-S). Secondary endpoints were change on the Health of the Nation Outcome Scales (HoNOS) and Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS).ResultsOf 32 completers who experienced a beneficial effect of memantine 23 patients continued memantine for one year. Memory improvement was sustained, verbal recognition memory improved even further between t = 26 weeks and t = 52 weeks. Continued treatment with memantine add-on to clozapine was associated with significantly improved PANSS positive, negative and overall score, CGI-S and HoNOS scores.ConclusionsIn the extension phase the positive effect of memantine add-on therapy on verbal memory sustained and positive, negative and overall symptoms of schizophrenia, clinical global status and psychosocial functioning significantly improved. Memantine was well tolerated without serious adverse effects.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Adjunctive Memantine in Clozapine-Treated Refractory Schizophrenia: An Open-Label One-Year Extension Study

2017 ◽  
Vol 41 (S1) ◽  
pp. S279-S280
Author(s):  
P. Schulte ◽  
S. Veerman ◽  
J.B. Deijen ◽  
L. De Haan
Keyword(s):  
Executive Function ◽  
Negative Symptoms ◽  
Controlled Trial ◽  
Extension Study ◽  
Favorable Effect ◽  
Long Term Effects ◽  
Open Label ◽  
Double Blind ◽  
Beneficial Effects ◽  
One Year

IntroductionIn a recent placebo-controlled, double blind crossover trial (n = 52), we found significant beneficial effects on memory (d = 0.30) and negative symptoms (d = 0.29) after 12 weeks memantine augmentation in patients with clozapine-refractory schizophrenia.AimsIn this open-label 1 year extension study, we report the long-term effects and tolerability of memantine add-on therapy to clozapine.MethodsCompleters of the first trial who experienced beneficial effects during 12 weeks of memantine treatment received memantine for one year. Primary endpoints were memory and executive function using the Cambridge neuropsychological test automated battery (CANTAB), the Positive and Negative Syndrome Scale (PANSS), and the Clinical Global Impression Severity Scale (CGI-S).ResultsOf 31 RCT completers who experienced beneficial effects from memantine, 24 received memantine for one year. The small improvement in memory found in the memantine condition in the placebo-controlled trial remained stable in the extension study. Executive function did not improve. After 26 weeks of memantine add-on therapy to clozapine, PANSS negative symptoms (r = 0.53), PANSS positive symptoms (r = 0.50), and PANSS total symptoms (r = 0.54) significantly improved. Even further significant improvement in all these measures was observed between 26 weeks and 52 weeks memantine, with effect sizes varying from 0.39 to 0.51. CGI-S showed a non-significant moderate improvement at 26 weeks (r = 0.36) and 52 weeks (r = 0.34). Memantine was well tolerated without serious adverse effects.ConclusionsIn the one-year extension phase, the favorable effect of adjunctive memantine on memory was sustained and we observed further improvement of positive, negative and overall symptoms of schizophrenia.Disclosure of interestP.F.J.S. reports personal fees from H. Lundbeck A/S, outside the submitted work and he is a board member of the Dutch Clozapine Collaboration Group. L.d.H., has received investigator-led research grants or recompense for presenting his research from Eli Lilly, Bristol-Myers Squibb, Janssen-Cilag and AstraZeneca.

scholarly journals Duration of untreated psychosis as predictor of long-term outcome in schizophrenia: systematic review and meta-analysis

2014 ◽  
Vol 205 (2) ◽  
pp. 88-94 ◽  
Author(s):  
Matti Penttilä ◽  
Erika Jääskeläinen ◽  
Noora Hirvonen ◽  
Matti Isohanni ◽  
Jouko Miettunen
Keyword(s):  
Negative Symptoms ◽  
Meta Analysis ◽  
Hospital Treatment ◽  
Duration Of Untreated Psychosis ◽  
Long Term Effects ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Positive Effects ◽  
Early Intervention In Psychosis

BackgroundDuration of untreated psychosis (DUP) is one of the few potentially modifiable predictors of outcomes of schizophrenia. Long DUP as a predictor of poor short-term outcome has been addressed in previous meta-analyses, but the long-term effects of DUP remain unclear.AimsTo analyse the associations between DUP and long-term outcomes of schizophrenia.MethodA systematic literature search was performed using seven electronic databases and manual searches. Random effects weighted meta-analysis with correlation coefficients was used to pool the results.ResultsWe identified 3493 unique publications, from which 33 samples met our predefined selection criteria. Long DUP correlated statistically significantly with poor general symptomatic outcome, more severe positive and negative symptoms, lesser likelihood of remission and poor social functioning and global outcome (correlations 0.13–0.18). Long DUP was not associated with employment, quality of life or hospital treatment.ConclusionsThe small but mostly consistent correlation between long DUP and poor outcome indicates that early intervention in psychosis may have at least subtle positive effects on the long-term course of illness.

scholarly journals Persistence of cognitive impairment and its negative impact on psychosocial functioning in lithium-treated, euthymic bipolar patients: a 6-year follow-up study

2012 ◽  
Vol 43 (6) ◽  
pp. 1187-1196 ◽  
Author(s):  
E. Mora ◽  
M. J. Portella ◽  
I. Forcada ◽  
E. Vieta ◽  
M. Mur
Keyword(s):  
Cognitive Impairment ◽  
Processing Speed ◽  
Verbal Memory ◽  
Psychosocial Functioning ◽  
Repeated Measures ◽  
Rating Scale ◽  
Psychosocial Adaptation ◽  
Analysis Of Covariance ◽  
Bipolar Patients

BackgroundPrevious cross-sectional studies report that cognitive impairment is associated with poor psychosocial functioning in euthymic bipolar patients. There is a lack of long-term studies to determine the course of cognitive impairment and its impact on functional outcome.MethodA total of 54 subjects were assessed at baseline and 6 years later; 28 had DSM-IV TR bipolar I or II disorder (recruited, at baseline, from a Lithium Clinic Program) and 26 were healthy matched controls. They were all assessed with a cognitive battery tapping into the main cognitive domains (executive function, attention, processing speed, verbal memory and visual memory) twice over a 6-year follow-up period. All patients were euthymic (Hamilton Rating Scale for Depression score lower than 8 and Young mania rating scale score lower than 6) for at least 3 months before both evaluations. At the end of follow-up, psychosocial functioning was also evaluated by means of the Functioning Assessment Short Test.ResultsRepeated-measures multivariate analysis of covariance showed that there were main effects of group in the executive domain, in the inhibition domain, in the processing speed domain, and in the verbal memory domain (p<0.04). Among the clinical factors, only longer illness duration was significantly related to slow processing (p=0.01), whereas strong relationships were observed between impoverished cognition along time and poorer psychosocial functioning (p<0.05).ConclusionsExecutive functioning, inhibition, processing speed and verbal memory were impaired in euthymic bipolar out-patients. Although cognitive deficits remained stable on average throughout the follow-up, they had enduring negative effects on psychosocial adaptation of patients.

Is the effect of topical intranasal steroids on obstructive adenoids transient or long-lasting? Case series and systematic review of literature

2016 ◽  
Vol 130 (4) ◽  
pp. 357-362 ◽  
Author(s):  
M A Bitar ◽  
J Nassar ◽  
R Dana
Keyword(s):  
Systematic Review ◽  
Case Series ◽  
Clinical Score ◽  
Review Of Literature ◽  
Long Term Effects ◽  
Positive Effects ◽  
Number Of Patients ◽  
Intranasal Steroids ◽  
One Year ◽  
Cessation Of Treatment

AbstractObjectives:To study and review the short- and long-term effects of intranasal steroids on obstructive adenoids.Methods:In this prospective cohort study, 19 children previously treated with mometasone furoate for 3 months were contacted at 3, 6 and 12 months after cessation of treatment. Main outcome measures included: change in severity of nasal obstruction, allergic rhinitis and obstructive symptoms. A systematic review of literature was also performed.Results:By one year, 25 per cent of patients required adenoidectomy; the remaining children had no significant change in clinical score (p = 0.464), obstruction severity (p = 0.191) or allergic symptoms (p = 0.284). Fourteen pertinent studies were identified; all but one study showed improvement in the patients’ symptoms and/or degree of obstruction. Two studies with follow up reaching 25 months showed positive effects.Conclusion:The short-term positive effect of some intranasal steroids on obstructive adenoids seems to persist in a significant number of patients after the cessation of treatment.

scholarly journals Machado-Joseph disease op azorean ancestry in Brazil: the Catarina kindred neurological, neuroimaging, psychiatric and neuropsychological findings in the largest known family, the «Catarina» kindred

1993 ◽  
Vol 51 (1) ◽  
pp. 21-30 ◽  
Author(s):  
J. Radvany ◽  
C.H.P. Camargo ◽  
Z.M. Costa ◽  
N.C. Fonseca ◽  
E.D. Nascimento
Keyword(s):  
At Risk ◽  
Verbal Memory ◽  
Visual Memory ◽  
Rating Scale ◽  
Age Of Onset ◽  
Quantitative Difference ◽  
Type I ◽  
History Of ◽  
The Moment ◽  
Fly Eye

At the moment 9 seemingly independent families with the clinical diagnosis of MJD are known in Brazil. The largest family tree of Azorean ancestry contatins 622 individuals in 9 generations. 236 were examined, 39 found to be affected by two examiners. Pheno-types I, II and III were expressed by 12, 23 and 4 patients with age of onset by phenotypea being 10-48, 14-54 and 30-55 respectively. Although clinically more severe, juvenile onset type I disease did not show as severe a ponto-mesencephialic atrophy on MRI as the father with type II disease of similar symptomatic duration. None of the 8 patients examined with MRI showed olivary atrophy or pallidal abnormalities. 12 affected and 23 at risk were evaluated with neuropsychological tests. Attention was normal in both groups. Verbal memory scores were below normal in the affected and there was greater decay with time than in the risk group. Both scored below normal in identifying silluettes and constructional praxis. Visual memory scores were well below normal for both, with many rotations but no omissions or confabulations. A peculiar pattern of multiplying internal details called «the fly-eye effect» was observed in 6 affected and 8 at risk. Defective color distinction when multiple colors presented close to each other, in face of proper naming of individual colors («color simultantagnosia»), was looked for in 29 people. 4/10 affected and 4/19 at risk showed this phenomenon. Cognitive dysfunctions in this MJD family are prominent in the sphere of vision. Whether they constitute an early manifestation in those at risk and thus serve as a clinical identifier of the illnes is yet to be established. Depression was looked for in the history of the family with DSM III-R criteria and an atempt at quantification with the Montgomery-Asberg Rating Scale. There was no significant quantitative difference between affected and at risk. Once undeniably symptomatic however, the patients had no, or less depression than themselves before or tat the early stages of the illness. Covert depression was appropriately excluded. Fully established MJD in this family seemed to exert a protective effect from depression.

scholarly journals Prevalence and correlates of antipsychotic polypharmacy among outpatients with schizophrenia attending a tertiary psychiatric facility in Nigeria

2016 ◽  
Vol 7 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Nosa Godwin Igbinomwanhia ◽  
Sunday Osasu Olotu ◽  
Bawo Onesirosan James
Keyword(s):  
Psychosocial Functioning ◽  
Side Effect ◽  
Negative Symptoms ◽  
Rating Scale ◽  
Cross Sectional Study ◽  
Global Assessment Of Functioning ◽  
Psychiatric Facility ◽  
Cross Sectional ◽  
Syndrome Scale ◽  
Negative Syndrome

Background: The study aimed to determine the prevalence, pattern and correlates of antipsychotic polypharmacy (APP) among outpatients with schizophrenia attending a tertiary psychiatric facility in Nigeria. Method: A cross-sectional study of 250 patients with schizophrenia attending the outpatient clinic of a regional tertiary psychiatric facility in Nigeria was undertaken. They were administered a sociodemographic questionnaire, the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF) scale and the Liverpool University Side Effects Rating Scale (LUNSERS). Results: Of the 250 subjects interviewed, 176 (70.4%) were on APP. APP was significantly associated with higher prescribed chlorpromazine equivalent doses of antipsychotics ( p < 0.001), increased frequency of dosing ( p < 0.001), negative symptoms ( p < 0.01), poorer functioning ( p = 0.04) and greater side-effect burden ( p = 0.04). Conclusion: The APP rate reported from this study is high. Clinicians should be mindful of its impact on dosage and side-effect profiles as APP use is associated with negative symptoms and poor psychosocial functioning.

scholarly journals The first experimental study of transference work–in teenagers (FEST–IT): a multicentre, observer- and patient-blind, randomised controlled component study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Randi Ulberg ◽  
Benjamin Hummelen ◽  
Anne Grete Hersoug ◽  
Nick Midgley ◽  
Per Andreas Høglend ◽  
...  
Keyword(s):  
Rating Scale ◽  
Work Group ◽  
Post Treatment ◽  
Psychoanalytic Psychotherapy ◽  
Secondary Outcome ◽  
Treatment Level ◽  
Long Term Effects ◽  
Link Type ◽  
One Year

Abstract Background Little is known about the influence on outcome of exploration of the patient-therapist relationship (that is, transference work) in psychoanalytic psychotherapy. We hypothesized that depressed adolescents would have better long-term effects from psychoanalytic psychotherapy with than without transference work. Methods Depressed adolescent (16 to 18 years) were recruited in health authority funded out-patient clinics in Oslo and Vestfold County, Norway. They were randomized to 28 weeks of treatment with psychoanalytic psychotherapy with or without transference work. Change was assessed using linear-mixed models. The primary outcome measure was the Psychodynamic Functioning Scale (pre- post-, and 1-year post-treatment). Level of depression was measured at the same time points and during therapy (week 12, and 20). Results 69 adolescents were treated with (N = 39) or without (N = 31) transference work. The mean number of sessions was 18.6 (SD = 8,6) in the transference work group and 18.0 (SD = 10.9) in the non-transference work group. Both groups showed large and significant improvement on Psychodynamic Functioning Scale during the whole study period. The difference between the two groups was not significant during the treatment period (95% CI −.79 to 1.2, p = .674, F = .18), or from post-treatment to one-year follow-up (95% CI −.13 to .96; p = .134; F = 2.3). For the secondary outcome measures the transference work group had significantly better outcomes from 12 weeks in treatment to one-year follow-up (Beck Depression Inventory, 95% CI − 1.7 to −.14, p = .022; Montgomery and Åsberg Depression Rating Scale, 95% CI − 1.6 to −.23, p = .009). Conclusion The findings suggest that exploration of the adolescents’ relations to the therapist amplify the effects of short-term psychoanalytic psychotherapy on their depressive symptoms for adolescents with a Major Depressive Disorder. Trial registration ClinicalTrials.gov. Id: NCT01531101. Registered 8 February 2012.

Duration of untreated psychosis and its correlates in first episode psychosis: results of the prospective 5-year follow-up study

2011 ◽  
Vol 26 (S2) ◽  
pp. 1534-1534
Author(s):  
Y. Zaytseva ◽  
I. Gurovich ◽  
A. Dorodnova ◽  
L. Movina ◽  
A. Shmukler
Keyword(s):  
Social Adjustment ◽  
Verbal Memory ◽  
Visual Memory ◽  
Negative Symptoms ◽  
Age Of Onset ◽  
Brain Regions ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Duration Of Untreated Psychosis

IntroductionDuration of untreated psychosis (DUP) is a potentially changeable prognostic factor which can also indicate neurodegenerative process in schizophrenia.ObjectiveTo examine the association of DUP with various characteristics of the course of schizophrenia in first episode patients during 5-year follow-up.MethodsOne-hundred-fourteen patients with first psychotic episodes who have been treated in naturalistic setting within Early Intervention Centre (Moscow Research Institute of Psychiatry) were included. Clinical, social and neuropsychological parameters were assessed using standardized instruments.ResultsThe mean duration of untreated psychotic symptoms before admission was 298.66 ± 447.35 days. According to the analysis DUP was found to be significantly associated with the mode of onset (r = 0.51, p ≤ 0.001) level of remission (r = 0.21–0.30, p ≤ 0.05), severity of positive symptoms and negative symptoms in remission mostly at 2nd, 3d and 4th years of observation, poorer level of social adjustment at the 5th year (r = 0.19, p ≤ 0.05). The effect of DUP remained significant after controlling for age, gender and diagnostic variables.Moreover, DUP correlated with the parameters of verbal memory, visual memory and spatial functions during the follow-up (r = 0.29–0.36, p ≤ 0.05, r = 0.28–0.30, p ≤ 0.05, respectively). No correlations have been found between DUP and the age of onset, number of relapses and their duration during 5-year follow-up as well as with other neurocognitive parameters (executive functioning, gnosis, praxis, attention).ConclusionsThe results of the study underline the prognostic value of DUP for predicting clinical and functional outcomes. Association between DUP and poor memory domains supports the notion of neurotoxicity of DUP grasping specific brain regions in schizophrenia.

scholarly journals Apathy, poor verbal memory and male gender predict lower psychosocial functioning one year after the first treatment of psychosis

2013 ◽  
Vol 210 (1) ◽  
pp. 55-61 ◽  
Author(s):  
Ann Faerden ◽  
Elizabeth Ann Barrett ◽  
Ragnar Nesvåg ◽  
Svein Friis ◽  
Arnstein Finset ◽  
...  
Keyword(s):  
Verbal Memory ◽  
Psychosocial Functioning ◽  
Male Gender ◽  
One Year

Beneficial effect of the addition of the 5-HT 2A/2C and α2 antagonist mianserin to ongoing haloperidol treatment in drug-resistant chronically hospitalized schizophrenic patients

2000 ◽  
Vol 15 (6) ◽  
pp. 388-390 ◽  
Author(s):  
A. Grinshpoon ◽  
A. Valevski ◽  
M. Moskowitz ◽  
A. Weizman
Keyword(s):  
Beneficial Effect ◽  
Rating Scale ◽  
Drug Resistant ◽  
Antipsychotic Activity ◽  
Schizophrenic Patients ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
One Year ◽  
Histamine H1 Receptors ◽  
Haloperidol Treatment

summaryAtypical neuroleptics that block serotonin 2A (5-HT 2A) and dopamine 2 (D2) receptors have been shown to possess efficacious antipsychotic activity. We assessed the efficacy of the addition of the 5-HT 2A/2C and α2 antagonist mianserin to ongoing haloperidol treatment in chronically hospitalized (> 10 years) drug-resistant schizophrenic patients (N = 12). The patients were assessed at baseline and every three months for one year with the Brief Psychiatric Rating Scale and the Clinical Global Impression. Results showed a significant (but < 10%) improvement in the core symptoms of schizophrenia; however, only the reduction (by 43%) in anxiety was clinically relevant (P < 0.0001). The beneficial effect of mianserin may be related to the combined blockade of 5-HT 2A and histamine (H1) receptors.

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