Effect in antipsychotic-induced hyperprolactinemia after switching to long-acting injectable aripiprazole: A 1-year study

2017 ◽  
Vol 41 (S1) ◽  
pp. s815-s816
Author(s):  
M. Juncal Ruiz ◽  
B. Fernández-Abascal Puente ◽  
O. Porta Olivares ◽  
M. Gómez Revuelta ◽  
R. Landera Rodríguez ◽  
...  

IntroductionAntipsychotic-induced hyperprolactinemia is associated with relevant side effects: short-term as hypogonadism, gynecomastia, amenorrhoea, sexual dysfunction and galactorrhoea; long-term as cardiovascular disease, bone demineralization and breast and prostate tumors.AimsTo evaluate the effect of switching to long-acting injectable aripiprazole on long-lasting antypsychotic-induced hyperprolactinemia.MethodsThis was a prospective observational 1-year study carried out in 125 outpatients with schizophrenia who were clinically stabilized but a switching to another antipsychotic was indicated. We measured the basal prolactine at the start of the study and 1 year after switching to long acting injecatable (LAI) aripiprazole.ResultsIn basal analytic, 48% had hyperprolactinemia (21.8–306.2 ng/mL) and 66.5% of them described side effects: 78% sexual dysfunction (72% men), 11% galactorrhoea (100% women), 5.5% amenorrhoea and 5.5% bone pain (100% women). In 48% of patients with hyperprolactinemia, the previous antipsychotics comprised: LAI-paliperidone (65,7%), oral-risperidone (7%), oral-olanzapine (6.1%), oral-paliperidone (5.2%), LAI-risperidone (4%) and others (12%). One year after switching to LAI-aripiprazole, prolactine levels were lower in all patients and in 85% prolactine levels were normalized. Overall, 72% described a clinical improvement, especially in terms of sexual dysfunction.ConclusionsSeveral studies have described an improvement of drug-induced hyperprolactinemia after switching to or adding oral aripiprazole. In our study, we observed that levels of prolactine were normalized in 85% of patients with a clinical improvement in almost all of cases. These findings suggest that switching to LAI aripiprazole may be an effective alternative for managing antipsychotic-induced hyperprolactinemia due to its partial agonism in D2 brain receptors, especially in tuberoinfundibular pathway.Disclosure of interestThe authors have not supplied their declaration of competing interest.

2017 ◽  
Vol 41 (S1) ◽  
pp. s822-s822
Author(s):  
I. Martínez Molina ◽  
N. Gómez-Coronado Suárez de Venegas ◽  
P. Blanco Ramón

IntroductionAripiprazole depot is an atypical antipshycotic used to treat positive and negative symptoms of psychosis or acute mania.AimDescribe the reason why psychiatrists switch the current antipsychotic treatment on to aripiprazol depot, its tolerability and the reasons to stop aripiprazol depot treatment.MethodsDescriptive analysis based on a sample of 37 patients, aged 18–65 years, treated during one year with antipsychotics at two community mental health units.ResultsSwitching on to aripiprazole depot principal reasons: promote adherence (25%), persistence of symptoms (25%) and high levels of prolactin or sexual dysfunction (16.66%):– side effects of aripiprazole depot: insomnia (11.11%), inquietude (8.33%), sexual dysfunction (2.77%) and hypertensive crisis during administration (2.77%);– 83.33% of the patients are still taking it after one year. The most common reasons to stop or change it were the presence of secondaries (11.11%) and clinical exacerbation (5.55%).ConclusionsAripiprazole depot is well tolerated (even better than other antipsychotics). Common side effects are not severe and appear in a small percent of patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2016 ◽  
Vol 33 (S1) ◽  
pp. s255-s256
Author(s):  
B. Fernández-Abascal Puente ◽  
M. Juncal Ruiz ◽  
R. Landera Rodríguez

IntroductionSwitching antipsychotics is a therapeutic alternative for managing side-effects, or efficacy and compliance issues.AimTo evaluate the efficacy and tolerability of switching to LAI-aripiprazole in patients who had insufficient response or were intolerant to the previous antipsychotic, or required a more convenient treatment regimen.MethodsThis was a prospective, observational, 6-months study carried out in 45 outpatients with schizophrenia who were clinically stabilized but a switching to another antipsychotic was clinically indicated. Patients who required hospitalization, treatment discontinuation or adding another antipsychotic (including supplementation with oral-aripiprazole) were considered treatment failures. Switching was considered successful if the side-effect/symptom/adherence/convenience improved or, if applicable, disappeared.ResultsPatients aged 38 years, 51% women, and previous antipsychotics comprised: LAI-paliperidone (42%), oral-aripiprazole (22%), oral-olanzapine (11%), oral-risperidone (7%), LAI-risperidone (4%) and others (14%). The efficacy results of the switching are presented in the table. Of the 45 patients, 7 (15%) were considered treatment failures: 3 patients were hospitalized due to recurrence of psychotic symptoms, 2 discontinued LAI-aripiprazole, and 2 required supplementation with oral-aripiprazole (Fig 1).ConclusionsOur results suggest that switching to LAI-aripiprazole is an efficacious strategy for managing some antipsychotic-induced side-effects, persistence of negative symptoms and/or lack of treatment adherence.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2016 ◽  
Vol 33 (S1) ◽  
pp. S579-S579 ◽  
Author(s):  
M. Juncal Ruiz ◽  
B. Fernández-Abascal Puente ◽  
R. Landera Rodríguez

IntroductionAntipsychotic-induced hyperprolactinemia (> 29 ng/ml in women) is associated with relevant side-effects.AimWe describe the case of two women aged 50 and 54 years, respectively, diagnosed with schizophrenia who were receiving outpatient treatment with paliperidone depot 100 mg/month and risperidone depot 50 mg/2 weeks, respectively and complained of oligoamenorrhoea and amenorrhoea for at least 6 months.MethodsRoutine blood tests showed hyperprolactinemia of 203.5 ng/ml and 306.2 ng/ml, respectively. The patients were evaluated by the Endocrinology unit and an MRI was performed discarding the presence of any primary brain condition. Both patients were switched to LAI aripiprazole due to its partial agonism of D2-brain receptors. At the time of switching both patients were stable in terms of psychopathology.ResultsChanges in prolactin levels 3 months after switching are shown in the Fig. 1. Two months after switching, both patients regained cyclic menstrual function. After 6 months, they still showed psycopathological stability.ConclusionsSeveral studies have described an improvement of drug-induced hyperprolactinemia after switching to or adding oral aripiprazole. In these two cases, the normalization of prolactin levels and the resolution of oligoamenorrhoea/amenorrhoea were observed as soon as 2–3 months after switching to LAI aripiprazole. These findings suggest that switching to LAI aripiprazole may be an effective alternative for managing antipsychotic-induced hyperprolactinemia.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2016 ◽  
Vol 33 (S1) ◽  
pp. S582-S582
Author(s):  
M.F. Molina López ◽  
M.C. Cancino Botello ◽  
A. Peña Serrano ◽  
M.D.L.A. Canseco Navarro

Introductionlong acting injectable formulations of antipsychotics are a valuable option for patients with schizophrenia, offering continuous medication delivery and stable dosage levels. Aripiprazole once-monthly is the first dopamine partial agonist available in long acting formulation approved in Europe for Schizophrenia with excellent results so far.Aimsto conduct a current review of articles related to the use and efficacy of Aripiprazole once monthly in patients with Schizophrenia.Methodssystematic review of the literature in English using the following keywords: “aripiprazole once-monthly”, “aripiprazole long acting formulation”, “schizophrenia”. PubMed database.ResultsAripiprazole once-monthly (AOM) formulation efficacy has been proven in many studies. The importance of maintaining an oral overlap during 14 days is highlighted in all studies that have been reviewed in order to reach therapeutic level; therefore, it can be used in patients with acute decompensations. Recent studies comparing AOM versus Paliperidone Palmitate once monthly (PP) have shown that patients with AOM had greater clinical improvement and, even though both drugs were well tolerated, when Quality of Life Style Scale was analyzed an important improvement in empathy, sense of purpose, emotional interaction and curiosity in the AOM group was observed.Conclusionslong acting injectable antipsychotics increase long-term adherence treatment and reduce risk of relapse. Because of its unique mechanism of action, Aripiprazole once-monthly improves positive and negative symptoms, giving the patient an opportunity to have a better quality of life.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2017 ◽  
Vol 11 (2) ◽  
pp. 440-445 ◽  
Author(s):  
Jenny Sarah Schneider ◽  
Matteo Montani ◽  
Felix Stickel

Adverse drug reactions are among the most frequent side effects of synthetic and complementary alternative drugs and represent the premier causes of license revocations and acute liver failure. Drug-induced liver injury can resemble literally any other genuine liver disease and usually responds well to drug dechallenge. However, in some cases autoimmune-like hepatitis can evolve, requiring short- and sometimes long-term immunosuppression. Here, we present the hitherto first case of autoimmune-like hepatitis following treatment with zoledronic acid.


2017 ◽  
Vol 41 (S1) ◽  
pp. S281-S281
Author(s):  
V. Farnia ◽  
F. Tatari ◽  
M. Alikhani ◽  
J. Shakeri ◽  
M. Taghizadeh ◽  
...  

IntroductionPatients with severe opioid dependency might be treated with methadone, a pure μ-opioid-receptor, with promising results. Though, as for opioids, side effects are high, and among those, sexual dysfunction is among the most disturbing side effects.AimsInvestigating the influence of Rosa Damascena oil to improve sexual dysfunction among male methadone users.MethodsA total of 60 male patients (mean age: 30 years) with diagnosed opioid dependence and currently under treatment of methadone were randomly assigned either to the verum (Rosa Damascenca oil drops) or placebo condition. At baseline, and four and eight weeks later, patients completed self-rating questionnaires covering sexual dysfunction and happiness.ResultsOver time sexual dysfunction decreased and happiness increased in the verum, but not in the placebo condition.ConclusionsResults from this double blind, randomized, and placebo-controlled clinical trial showed that Rosa Damascena oil improved sexual dysfunction and happiness among male opioid addicts while under substitution treatment with methadone.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 3587-3587
Author(s):  
Laura Diane Porter ◽  
Ronit Yarden ◽  
Kim Lynn Newcomer ◽  
Negeen Fathi ◽  

3587 Background: Colorectal cancer is the third-most commonly diagnosed cancer and the second-leading cause of cancer death in men and women combined in the United States. Young-onset colorectal cancer refers to individuals diagnosed under the age of 50. In recent years, the incidence has increased by 2.2% annually in individuals younger than 50 years and 1% in individuals 50-64, in contrast to a 3.3% decrease in adults 65 years and older. Young-onset (YO) CRC patients and survivors face unique clinical challenges with fertility and sexual dysfunctions, but this risk is not well quantified. There is limited data and public discussion on the long-term effects of colorectal cancer treatments on fertility and sexual dysfunction and the long-term impact on the quality of life. Methods: To explore the unique challenges and unmet needs of the young-adult patient population, a cross-sectional study was conducted. Colorectal cancer patients and survivors (N = 884) diagnosed between the ages of 20 to 50 years old (median age 42 ± 7.0) completed an online questionnaire based on established instruments EORTC-QOL-30, EORTC-CR-29, and EORTC-SHC-22. Results: Thirty-one percent of respondents stated that a medical professional spoke to them about fertility preservation at the time of diagnosis and during treatment. Only 31% were referred to a reproductive endocrinologist, even though 37% of women and 16% of men reported that treatment left them infertile or sterile. Among survey respondents, 12% of women had an egg retrieval procedure, and 36% of men had their sperm preserved prior to the start of treatment. Fifty-three percent of women reported treatment led to premature menopause. Sixty-five percent of respondents suffer from some level of sexual dysfunction due to treatment. In patients who received radiation therapy, women were 12% less likely than men to have discussed sexual side effects with the provider before treatment. Patients who have an ostomy reported more severe sexual dysfunction (17.8%). Rectal cancer patients were 2.5 times more likely than those with colon cancer to report severe dysfunction after their treatment. More than 25% of the respondents said they would have considered alternative treatment if they would have known the risks of sexual dysfunction. Conclusions: Our survey demonstrates inadequate communications between patients and providers about the irreversible fertility and sexual effects of colorectal cancer treatments. Younger patients and survivors face unique long-term challenges and require further information about fertility preservation options and emotional support regarding their sexuality post-treatment. Other studies are needed to assess the physical and psychological side effects endured by young-onset CRC patients and survivors.


2016 ◽  
Vol 33 (S1) ◽  
pp. S591-S591
Author(s):  
O.W. Muquebil Ali Al Shaban Rodriguez ◽  
S. Ocio León ◽  
M. Gómez Simón ◽  
M.J. Hernández González ◽  
E. Álvarez de Morales Gómez-Moreno ◽  
...  

IntroductionThe side effects of the various antidepressant drugs on the sexual field (with very few exceptions) are well known, and they affect the quality of life in important manners. The incidence rate, communicated spontaneously by the patient, has been estimated around 10–15%, and can reach amounts of 50–60% with SSRIs when studied specifically. It has been suggested that these effects compromise treatment adherence.ObjectivesTo estimate the incidence and intensity of the side effects on the sexual field with different antidepressants, as well as its relationship with treatment adherence.MethodologyTransversal study on 50 patients assisted in medical consultation. Collection of data in office (October 2014–October 2015).Administration of survey PRSexDQ-SALSEX. In order to research the relationship with treatment adherence, one question surveyed the patient whether he/she had thought about finishing treatment for this reason.ResultsTwenty-nine patients (58% of the sample) presented some degree of sexual dysfunction. Five individuals (17.2%) communicated it spontaneously. Nine individuals (31%) responded that they did not accept positively the changes in their sexual field, and they had thought about withdrawing treatment for this reason. They were given the test of self-compliance statement (Haynes-Sackett), with a result of four non-compliant (44.4%). The most frequently involved drugs were fluoxetine (n = 5, 10% of the sample total) and paroxetine (n = 4, 8%).ConclusionsThe high impact of sexual side effects with a low rate of spontaneous communication coincides with previous existent studies.Limitation when estimating adhesion due to methodological difficulties in the design of the study. However, high impression by using the selected method of determination.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2007 ◽  
Vol 8 (1) ◽  
pp. 90-96 ◽  
Author(s):  
Dilek Şengün ◽  
Hasan Hatipoğlu ◽  
Müjgan Güngör Hatipoğlu

Abstract Hereditary gingival fibromatosis (HGF) is a rare condition characterized by varying degrees of gingival hyperplasia. Gingival fibromatosis usually occurs as an isolated disorder or can be associated with a variety of other syndromes. A 33-year-old male patient who had a generalized severe gingival overgrowth covering two thirds of almost all maxillary and mandibular teeth is reported. A mucoperiosteal flap was performed using interdental and crevicular incisions to remove excess gingival tissues and an internal bevel incision to reflect flaps. The patient was treated 15 years ago in the same clinical facility using the same treatment strategy. There was no recurrence one year following the most recent surgery. Citation Şengün D, Hatipoğlu H, Hatipoğlu MG. Long-term Uncontrolled Hereditary Gingival Fibromatosis: A Case Report. J Contemp Dent Pract 2007 January;(8)1:090-096.


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
B. Luft ◽  
E. Berent

Introduction:Long-acting depot antipsychotic medication is associated with extrapyramidal side effects (EPS). This may reduce adherence to medication, and precipitate relapse (1). Clearly, EPS is a major drawback and early detection is essential. However, in an earlier review of patients’ medical notes, we identified only one patient with an examination that recorded the presence of EPS. Despite the fact that a number of rating scales are available. We proposed that the application of these rating scales, would allow us to improve the assessment of EPS.Method:All patients prescribed a depot antipsychotic or long-acting risperidone injection, were identified. the Barnes Akathisia Scale (2) was chosen to rate akathisia, a modified Simpson-Angus scale (3) was chosen to rate parkinsonism and the Abnormal Involuntary Movement Scale (4) was chosen to rate tardive dyskinesia.Results:A total of 43 patients were evaluated. 23 (53%) patients showed drug induced EPS. the total number of positive cases of akathisia was 12 (28%), and 10 (23%) patients were found to have tardive dyskinesia. 13 (30%) patients were found to have drug induced parkinsonism.Conclusions:Our screening programme has identified high rates of previously undiscovered drug induced EPS.


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