Prescription profile of antipsychotics in inpatients with psychotic disorders

2016 ◽  
Vol 33 (S1) ◽  
pp. S612-S612
Author(s):  
M.D.C. García Mahía ◽  
Á. Fernández Quintana ◽  
M. Vidal Millares
Keyword(s):  
Psychotic Disorders ◽  
Treatment Resistance ◽  
Psychiatric Inpatients ◽  
Total Sample ◽  
Response To Treatment ◽  
Typical Antipsychotic ◽  
Concurrent Use ◽  
Significant Difference ◽  
Schizophrenic Patients ◽  
Competing Interest

IntroductionPrevious studies of prescribing in psychiatric services have identified the relatively frequent use of combined antipsychotics in schizophrenia.Aims– To analyze the proportion of patients treated with more than one antipsychotic;– to study clinical as sociodemographic variables associated with types of prescription.MethodsRetrospective descriptive study of treatment prescribed to psychiatric inpatients treated in an acute care unit of Psychiatry Service in a large teaching hospital during a period of 3 years. Consecutively admitted inpatients receiving concurrent antipsychotics were compared with those treated with a single antipsychotic. Prescription drug records at discharging were revised, n = 263.ResultsFrom the total sample, 61% received more than one antipsychotic. The most common types of combinations were atypical plus a typical antipsychotic followed by two atypical antipsychotics, being less frequent combination of three or more antipsychotics. There were 19 different drug combinations. Concurrent antipsychotics were most frequently prescribed in schizophrenia and schizoaffective disorder. Patients with more previous episodes of illness received more frequently concurrent antipsychotics than patients with low number of previous episodes of illness (P < 0.03). Patients with longer time of hospitalization, and age between 30 and 50 years were treated more frequently with several antipsychotics. Analysis with other variables is presented in the study.ConclusionsThere is a significant difference in the strategies of treatment with antipsychotics depending on diagnosis and number of previous episodes of illness. The concurrent use of multiple antipsychotics in psychiatric inpatients appears to be a response to treatment resistance and is frequent in schizophrenic patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Relapse After First-Episode Psychosis: A 3-Year Follow-Up

2017 ◽  
Vol 41 (S1) ◽  
pp. S276-S276
Author(s):  
E. Pereira ◽  
M. Mota Oliveira ◽  
R. Guedes ◽  
M.J. Peixoto ◽  
I. Ferraz ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Statistical Significance ◽  
First Episode Psychosis ◽  
Response To Treatment ◽  
First Episode ◽  
Final Sample ◽  
Episode Psychosis ◽  
Competing Interest ◽  
Relapse Rates

IntroductionRelapse after first-episode psychosis (FEP) is a frequent problem, which can lead to patients’ poorer functioning and response to treatment. Its prevention is one of the most important and challenging targets in the treatment of psychotic disorders.ObjectivesTo characterize and evaluate relapse rates after FEP, during the course of 3 years, of a group of patients admitted at a psychiatry department.MethodsA retrospective observational study was conducted. Patients with a FEP between ages 18 to 40, admitted at the Clinic of Psychiatry and Mental Health at São João Hospital Centre between January 1, 2007 and September 30, 2013. Only patients with, at least, 3 years of follow-up at the clinic were included.ResultsFinal sample of 58 patients, 39 of which were male (mean age = 26.4 years). Forty patients were excluded by not completing the 3 years follow-up at our department. The cumulative relapse rates were 32.8% at 12 months, 53.4% at 24 months and 63.8% at 36 months. Patients with at least one relapse were younger (25.78 years vs. 27.52 years) and had shorter periods of first hospitalization (19.25 days vs. 23.52 days). These data did not reach statistical significance. Non-adherence to prescribed medication was described in 73.0% (n = 27) of patients at the time of relapse. Eight of them (21.6%) presented with cannabis use.ConclusionsAlthough no statistical significance was reached, our findings are consistent with other studies. A future study with a bigger sample would be important in achieving statistical significant results.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Comparative study of psychiatric comorbidity differences in patients with ADHD and cocaine substance use disorders and patients ADHD and cannabis use disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S477-S477
Author(s):  
N. Martínez-Luna ◽  
L. Rodriguez-Cintas ◽  
C. Daigre ◽  
L. Grau-Lopez ◽  
R.F. Palma-Alvarez ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Drug Users ◽  
Psychiatric Comorbidity ◽  
Psychotic Disorders ◽  
Neuronal Damage ◽  
Total Sample ◽  
Cocaine Users ◽  
The Difference ◽  
Competing Interest

Substance Use Disorders (SUD) and Attention Deficit Hyperactive Disorder (ADHD) are frequent conditions in out drug treatment centers. There are evidences about the high prevalence of ADHD in SUD patients (20%) compared with just ADHD in general population (1–7.3%). Both disorders and psychiatric comorbidity are important in the diagnosis proceeding. The objective of this study is search the difference in psychiatric comorbidity conditions between patients with ADHD and Cocaine SUD and ADHD and Cannabis SUD. ADHD was present in 158 patients of a total sample in which 46,8% used cocaine, 17.1% cannabis and 36.1% used both. Mood disorders were 26.8% in cocaine users, 21.7% in cannabis and 18.9% in both. Anxiety disorders were 20.3% in cocaine users, 37.5 in cannabis and 13% in both users. Primary psychotic disorders were 2.9% in cocaine users, none in cannabis and 11,1% in both drug users. Personality disorders by cluster were, Cluster A: 11.3% in cocaine group, 36% in cannabis group and 24.5 in cannabis and cocaine group. Cluster B: 33.8% in cocaine group, 44% in cannabis group and 51.9% in cannabis and cocaine group. Cluster C: 9.9% in cocaine group, 28% in cannabis group and 19.2% in cannabis and cocaine group. There could be common pathways of neuronal damage related to psychiatric comorbidity depending of used drug, the differences in comorbidity found in this study could explain a little part of it. It is important to manage SUD-ADHD and other psychiatric comorbidity in order to improve the outcomes of these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Systematic Review on Loxapine: A Typical Antipsychotic Drug Used to Treat Agitation in Schizophrenic Patients

2021 ◽  
pp. 193-200
Author(s):  
Abdul Halim ◽  
Ritika Puri
Keyword(s):  
Antipsychotic Drug ◽  
Heterocyclic Ring ◽  
Dosage Forms ◽  
Oral Dosage ◽  
Time Range ◽  
Typical Antipsychotic ◽  
Onset Of Action ◽  
Increased Risk ◽  
Significant Difference ◽  
Schizophrenic Patients

Loxapine is an antipsychotic drug used in neuroleptic disorders since 1980 with an entrenched drug profile. Drug possesses dibenzoxazepine tricyclic 7-membered heterocyclic ring available commercially as oral, intramuscular and inhalation dosage forms. This review comprises the various study designs of loxapine irrespective of its dose formulations. A comprehensive and systematic search was conducted on “Scopus”, “Web of science” and “Pub-med” data base and findings were critically analyzed. The data suggests that there is no significant difference in efficacy between typical and atypical antipsychotics.  Till now, oral and intramuscular route is widely in use. Oral dosage forms are available in the market for the treatment of agitation related to schizophrenia but it has limitation of delayed onset of action that results in increased risk. Intramuscular formulations reveal a significant difference compared to placebo with respect to agitation but time range could be in range of 15 to 60 minutes. Therefore, there is a need for a novel drug delivery system with rapid action, increased half life, better tolerance by the patient and sustained release to get enhanced patient compliance.

Evaluation of suicide risk in psychiatric patients after discharge. A follow-up study

2016 ◽  
Vol 33 (S1) ◽  
pp. s282-s282
Author(s):  
G. Giordano ◽  
R. Federica ◽  
E. Denise ◽  
M. Monica ◽  
I. Marco ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Suicide Risk ◽  
Attempted Suicide ◽  
Psychiatric Patients ◽  
Psychiatric Inpatients ◽  
Type I ◽  
Follow Up Study ◽  
Significant Difference ◽  
Competing Interest

RésuméIntroductionSeveral studies show that the first period after discharge has an higher suicide risk.ObjectivesFollowing up psychiatric inpatients after discharge may be important in order to better understand the risk and the protective factors of suicide.AimThe aim of our follow-up study is to evaluate the predictive factors of suicide in a sample of psychiatric inpatients after discharge.MethodsWe analyzed the temperament and the levels of hopelessness, depression, suicide risk in a sample of 87 (54% males) inpatients at time T0 (during the hospitalization), T1 (12 months after discharge) and T2 (8 months after T1). We administered the following scales: BHS, MINI, TEMPS, GMDS, CGI.ResultsA statistically significant difference on the risk of suicide with substance abuse was found among patients who were followed up and who refused to participate, respectively at T1 (χ24 = 2.61; P < 0.05) and T2 (χ24 = 1.57; P = 0.05). At T1, 4 patients attempted suicide and 18 showed suicidal ideation. In the second follow-up, 1 patient successful committed suicide, 1 subject attempted suicide and 10 patients showed suicidal ideation. Patients with suicidal ideation at T1 showed higher levels of hopelessness and a diagnosis of bipolar disorder type I (χ24 = 10.28; P = 0.05). Sixty-seven percent of subjects with suicidal ideation showed higher scores in the BHS at T1. Significant differences were found on the anxious temperament at T2 between two groups.ConclusionsThe follow-up could represent a significant strategy to prevent suicide in psychiatric patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Lack of Association between the IL6R Gene Asp358Ala Variant (rs2228145), IL-6 Plasma Levels, and Treatment Resistance in Chilean Schizophrenic Patients Treated with Clozapine

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Alvaro Cavieres ◽  
Carolina Campos-Estrada ◽  
Yanneth Moya ◽  
Rocío Maldonado ◽  
René González-Vargas ◽  
...  
Keyword(s):  
Plasma Levels ◽  
Rating Scale ◽  
Receptor Gene ◽  
Treatment Resistance ◽  
Response To Treatment ◽  
Clozapine Treatment ◽  
Interesting Candidate ◽  
Schizophrenic Patients ◽  
Inflammatory System

Alterations in neuroinflammatory processes have been suggested to contribute to the development of Schizophrenia (SZ); one component of the inflammatory system that has been linked to this disorder is interleukin-6 (IL-6). The minor allele of rs2228145, a functional polymorphism in the IL-6 receptor gene, has been associated to elevated IL-6 plasma levels and increased inflammatory activity, making it an interesting candidate to study as a possible factor underlying clinical heterogeneity in SZ. We studied a sample of 100 patients undergoing treatment with clozapine. Their symptoms were quantified by Brief Psychotic Rating Scale; those with the lowest scores (“remitted”) were compared with the highest (“clozapine treatment resistant”). We determined allelic frequencies for rs2228145 and IL-6 plasma levels. Our results do not support a role of IL-6 in response to treatment with clozapine. Further studies accounting for potential confounding factors are necessary.

Treatment-resistant schizophrenia during life span : Epidemiology, outcomes and innovative M-Health treatments within M-RESIST Project

2016 ◽  
Vol 33 (S1) ◽  
pp. S35-S35
Author(s):  
K. Rubinstein
Keyword(s):  
Psychotic Disorders ◽  
Clinical Importance ◽  
Treatment Resistance ◽  
The European Union ◽  
Treatment Resistant ◽  
Time Data ◽  
Information And Communication ◽  
Competing Interest ◽  
Definition Of ◽  
Psychosocial Approaches

Treatment-resistant symptoms of schizophrenia (TRS) complicate the clinical course of the illness, and a large proportion of patients do not reach functional recovery (Englisch and Zink, 2012). Out of the estimated 5 million people (0.2–2.6 %) suffering from psychotic disorders in the European Union, 30-50 % can be considered resistant to treatment, and 10–20 % ultra-resistant (Essock et al., 1996 ; Juarez-Reyes et al., 1995). The complexity of standard intervention within this population, along with the presence of persistent positive symptomatology, extensive periods of hospital care and greater risk of multi-morbidity, lead to a high degrees of suffering for the patients, family and social environment, and a high proportion of costs to the healthcare system (Kennedy et al., 2014).At present, a uniform definition of treatment resistance in the pharmacotherapy of schizophrenia is not available (Suzuki et al., 2011), as well as generally recommendable evidence-based treatment methods (Dold and Leucht, 2014).A recent systematic review on the topic showed that TRS is poorly a studied and understood condition, contrasted to its high prevalence, clinical importance and poor prognosis. There is lack of studies on epidemiology and risk factors of this disorder, as well as on outcomes and longitudinal course. Most of the available literature focuses on medication treatments, while very few examine efficacy of adjunctive therapeutic options (Seppala et al., in preparation).Treatments based on information and communication technology (ICT) present novel possibilities to improve the outcomes of schizophrenia. Previous studies have indicated suitability and promising results of such intervention techniques (Granholm et al., 2012 ; Ben-Zeev et al., 2013). m-RESIST is an innovative project aimed to empower patients with resistant schizophrenia, to personalize treatment by integrating pharmacological and psychosocial approaches, and to further develop knowledge related to the illness using predictive models designed to exploit historical and real-time data based on environmental factors and treatment outcomes.Disclosure of interestThe author has not supplied his declaration of competing interest.

Risperidone: Treatment Response in Adult and Geriatric Patients

1998 ◽  
Vol 28 (2) ◽  
pp. 255-263 ◽  
Author(s):  
S. J. Kiraly ◽  
R. E. Gibson ◽  
R. J. Ancill ◽  
S. G. Holliday
Keyword(s):  
Side Effects ◽  
Treatment Response ◽  
Geriatric Patients ◽  
Psychotic Disorders ◽  
Late Onset ◽  
Diagnostic Category ◽  
Best Response ◽  
Concurrent Use ◽  
Significant Difference ◽  
And Behavior

Objective: to Compare the Efficacy and Side Effects of Risperidone in Younger Adult and Geriatric Patients. Methods: Open Retrospective Study of 102 Consecutive Intakes, prescribed risperidone, by a mental health team. All patients were non-hospitalized community residents. Prior to initiation of risperidone, and at termination of study period, Clinical Global Impression (CGI) scores were used to track progress. Variables monitored were: concurrent use of other antipsychotics, compliance, side effects, and maintenance dosage. Results: The most common DSM-IV diagnoses were schizophrenia in the younger adult group and late onset delusional disorders in the geriatric group. Compliance was good for both groups. The geriatric group demonstrated a greater treatment response which was reached at a significantly lower dosage. There was no statistically significant difference in the occurrence of side effects. Examination of response by diagnostic category indicated that geriatric patients with late onset delusional disorder showed the best response while adults with either schizophrenia or affective syndromes also showed positive response. Conclusions: Risperidone, at lower than recommended doses, shows promise in the treatment of late onset delusional disorders and behavior syndromes of dementia. The side effect profile was benign, as was suggested by experience in treating schizophrenia. Scientifically more rigorous prospective studies for the indications and efficacy of risperidone in late onset psychotic disorders and psychoses and behavior syndromes associated with dementing illness are overdue.

scholarly journals Quality of life of schizophrenic patients treated with haloperidol depot and injection preparation of long-lasting risperidone

2011 ◽  
Vol 139 (suppl. 1) ◽  
pp. 36-40 ◽  
Author(s):  
Goran Mihajlovic ◽  
Natalija Jovanovic-Mihajlovic ◽  
Branimir Radmanovic ◽  
Katarina Radonjic ◽  
Slavica Djukic-Dejanovic ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Satisfaction With Life ◽  
Satisfaction With Life Scale ◽  
Typical Antipsychotic ◽  
Significant Difference ◽  
Quality Of Life Scale ◽  
Life Scale ◽  
Schizophrenic Patients ◽  
Long Acting

Introduction. In the last decades psychiatric patients? quality of life attracts great attention of researchers. Improving the quality of life of schizophrenic patients is increasingly becoming an imperative in pharmacological therapy. Objective. Analysis of certain aspects of quality of life in patients with schizophrenia treated with depot formulations of a typical antipsychotic (haloperidol) and injection preparation of a long-acting atypical antipsychotic (risperidone). Methods. Research was conducted as a cross-sectional study that included 60 patients of both genders. Examinees diagnosed with schizophrenia (ICD-10, F20.0-F20.9) were divided into two groups: the group of patients that received haloperidol depot (n=30) and the group of patients that received injection preparation of long-acting risperidone (n=30). In order to assess the quality of life, social functioning scale (SFS), satisfaction with life scale (SWLS), and short version of World Health Organization quality of life scale (WHO-QoL-Brief) were applied. Results. Results showed statistically significant differences when it comes to social activity and satisfaction with life in favour of patients treated with injection preparation of long-acting risperidone. Examinees from this group were much more satisfied with themselves, their health and sleep compared to those on haloperidol depot. There was no statistically significant difference found on the quality of life scale. Conclusions. Applying the scales for the assessment of the quality of life of schizophrenic patients in terms of psychosocial functioning, statistically significant difference between groups was found. Results showed higher scores in the group of patients treated with injection preparation of long-acting risperidone concerning social activities and life satisfaction.

Patricide, Matricide: A Comparative Study Among Tunisian Patients With Psychotic Disorders

2016 ◽  
Vol 33 (S1) ◽  
pp. S459-S459 ◽  
Author(s):  
B. Ghajati ◽  
S. Ghezaiel ◽  
R. Chebbi ◽  
I. Berrahal ◽  
R. Ridha
Keyword(s):  
Comparative Study ◽  
Psychotic Disorders ◽  
Criminal Code ◽  
Professional Status ◽  
Significant Difference ◽  
Instructional Level ◽  
Tunisian Patients ◽  
Dsm Iv ◽  
Competing Interest ◽  
Conflictual Relationship

Parricide is defined as the homicide of a father or mother by a biological or adopted child. In adults, it is generally associated to a psychotic condition. Scientific research on the subject, have been mainly interested in matricide, patricide or double parricide. Studies comparing authors of patricide to those of matricide are rare.ObjectivesTo compare socio-demographic and clinical profiles of patricide and matricide patients.To compare modus operandi in matricide and patricide patients.MethodsA retrospective, descriptive and comparative study was conducted, based on medical charts’ consult. Were included patients suffering from psychotic disorders (DSM-IV), hospitalized in the forensic psychiatry department of Razi hospital between 1995 and 2015, after not being held for insanity according to article 38 of Tunisian Criminal Code. Only patients who committed patricide or matricide were included.ResultsOur sample included 26 patients (13 patricides; 13 matricides). There was non-significant differences between two groups concerning: instructional level (P = 0.277), professional status (P = 0.387) and marital status (P = 0.790). Committers of patricide and matricide did not differ in terms of psychiatric diagnosis (P = 0.242) and substance abuse (P = 0.550). A significant difference was found between the two groups in terms of schizophrenia subtypes, patricide patients suffered from a disorganized schizophrenia whereas matricide patients suffered from paranoid subtype (P = 0.05). Patricide was more frequently associated to a conflictual relationship between son and father (P = 0.05). We did not record a significant difference in the crime weapon or its motivations.ConclusionOur results helps draw a profile for parricide patients in order to help identify the ones at risk.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Sexual dysfunctions and treatment compliance in individuals with psychotic disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S342-S342
Author(s):  
G. Unsal ◽  
S. Karaca ◽  
N. Onan ◽  
Y. Can Oz ◽  
S. Aydın ◽  
...  
Keyword(s):  
Sampling Method ◽  
Psychotic Disorders ◽  
Compliance Rate ◽  
Treatment Compliance ◽  
Sexual Problems ◽  
Sexual Dysfunctions ◽  
Significant Difference ◽  
Weak Negative Correlation ◽  
Competing Interest

IntroductionSexual dysfunctions are more common in individuals with psychotic disorders and has a major impact on both quality of life and compliance.ObjectivesThe purpose of this study is to investigate whether a relationship between sexual dysfunction and level of treatment compliance in individuals with psychotic disorders.MethodsThe sample group of the study consisted of 173 in-patients who agreed to participate were selected by random sampling method. The permission was obtained from the hospital's ethics committee. In this study, to assess the sexual functionality Golombok-Rust inventory of sexual satisfaction male and female form and to assess the treatment compliance; medical treatment compliance rate scale is used.ResultsWhen sexual problems and treatment compliance compared to gender, subscales of satisfaction (t = 4,423, P = 0.000), avoidance (t = 3.348, P = 0.001), touch (t = 2.165, P = 0.032) and overall total (t = 4.015, P = 0.000), although a statistically significant difference was found, there were no differences in treatment compliance. Aditionally, there is no relation between sexual problems and treatment compliance in men. It is also found that there is a weak negative statistical relation amongst treatment compliance and communication (r = −0.244, P = 0.027), avoidance (r = −0.270, P = 0.014), anorgasmia (r = −0.253, P = 0.022) and overall total (r = −0.249, P = 0.024) in women. According to these findings while sexual problems increase, treatment compliance decreases.ConclusionsThe level of compliance to the treatment and subscales of sexual problems; satisfaction, avoidance, and touch mean scores differ from each other. There was a weak negative correlation in between Women's compliance and sexual problems.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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