Association of MTHFR 677C > T genetic polymorphism with extrapyramidal side effects of antipsychotic treatment

SummaryRecent advances in antipsychotic treatment of schizophrenia have offered several new compounds which avoid many of the limitations of the classical antipsychotics. These so-called ‘atypical’ antipsychotics have fewer extrapyramidal side effects, greater efficacy against negative symptoms and greater efficacy in otherwise treatment-resistant patients. However, the mechanism of action of these atypical antipsychotics is still unclear. The several receptors currently implicated in the pharmacological profile of these atypical antipsychotics include subtypes of those for dopamine, serotonin, noradrenaline, and acetylcholine among others. The current hypotheses for possible mechanisms of action of atypical antipsychotics are discussed along with the experimental correlates of antipsychotic efficacy in animal models.

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CYP2D6 genetic polymorphism and extrapyramidal side effects of antipsychotic drugs

European Neuropsychopharmacology ◽

10.1016/s0924-977x(02)80355-8 ◽

2002 ◽

Vol 12 ◽

pp. 266

Author(s):

B.Kores Plesnicar ◽

V. Dolzan ◽

B. Zalar ◽

M. Tomori ◽

K. Breskvar

Keyword(s):

Genetic Polymorphism ◽

Side Effects ◽

Antipsychotic Drugs ◽

Extrapyramidal Side Effects

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Extrapyramidal Side Effects of Antipsychotic Treatment: Scope of Problem and Impact on Outcome

Annals of Clinical Psychiatry ◽

10.3109/10401230209149099 ◽

2002 ◽

Vol 14 (2) ◽

pp. 123-129 ◽

Cited By ~ 58

Author(s):

Rajiv Tandon ◽

Michael Jibson

Keyword(s):

Side Effects ◽

Antipsychotic Treatment ◽

Extrapyramidal Side Effects

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Acute effects of treatment for prodromal symptoms for people putatively in a late initial prodromal state of psychosis

The British Journal of Psychiatry ◽

10.1192/bjp.191.51.s88 ◽

2007 ◽

Vol 191 (S51) ◽

pp. s88-s95 ◽

Cited By ~ 95

Author(s):

Stephan Ruhrmann ◽

Andreas Bechdolf ◽

Kai-Uwe Kühn ◽

Michael Wagner ◽

Frauke Schultze-Lutter ◽

...

Keyword(s):

Side Effects ◽

Negative Symptoms ◽

Controlled Study ◽

Psychotic Symptoms ◽

Antipsychotic Treatment ◽

Extrapyramidal Side Effects ◽

Acute Effects ◽

Global Functioning ◽

Prodromal Symptoms ◽

Symptomatic Benefit

BackgroundPeople in a putatively late prodromal state not only have an enhanced risk for psychosis but already suffer from mental and functional disturbancesAimsTo evaluate the acute effects of a combined supportive and antipsychotic treatment on prodromal symptomsMethodPutatively prodromal individuals were randomly assigned to a needs-focused intervention without (n=59) or with amisulpride (n=65). Outcome measures at 12-weeks effects were prodromal symptoms, global functioning and extrapyramidal side-effectsResultsAmisulpride plus the needs-focused intervention produced superior effects on attenuated and full-blown psychotic symptoms, basic, depressive and negative symptoms, and global functioning. Main side-effects were prolactin associatedConclusionsCoadministration of amisulpride yielded a marked symptomatic benefit. Effects require confirmation by a placebo-controlled study

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Monitoring of extrapyramidal side effects in patients on antipsychotic treatment: a completed audit cycle

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2015.27 ◽

2015 ◽

Vol 33 (3) ◽

pp. 165-169 ◽

Cited By ~ 1

Author(s):

MI Butler ◽

J Chandrakanth

Keyword(s):

Side Effects ◽

Current Practice ◽

Antipsychotic Treatment ◽

Patient Records ◽

Extrapyramidal Side Effects ◽

Teaching Session ◽

Confidence Levels ◽

Hospital Doctors ◽

Audit Cycle ◽

Clinical Records

BackgroundMovement disorders are a common problem in those receiving antipsychotic medication. Clinical guidelines recommend that these side-effects are monitored regularly throughout treatment. However, due to a lack of training, clinician confidence levels in assessment are often low and regular monitoring may be neglected.AimsTo audit current practice in our services regarding monitoring of extrapyramidal side effects (EPSE) and improve monitoring through education of clinicians.MethodThe clinical records of patients receiving antipsychotic treatment, seen in the outpatient clinic over a 2-week period, were reviewed. Data were collected on whether or not EPSE had been assessed. A re-audit was undertaken following a teaching session.ResultsDocumentation regarding EPSE was present in only 14% of patient records. Following a teaching session, the overall level of documentation of EPSE rose to 42%, with rates of assessment dramatically improving in non-consultant hospital doctors.ConclusionIn our practice, clinicians are generally poor to assess and record EPSE. However, rates of assessment improved significantly following a teaching session, especially in NCHDs.

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Clozapine-induced intestinal obstruction - a critical examination of four cases

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v12i1.50 ◽

2006 ◽

Vol 12 (1) ◽

pp. 4

Author(s):

C Seller ◽

L Koen ◽

D J H Niehaus

Keyword(s):

Side Effects ◽

Negative Symptoms ◽

Critical Examination ◽

Antipsychotic Treatment ◽

Extrapyramidal Side Effects ◽

Atypical Antipsychotic Drug ◽

Superior Efficacy ◽

Added Benefit ◽

Treatment Refractory ◽

Positive And Negative Symptoms

Clozapine is an atypical antipsychotic drug indicated for the management of severely ill patients with schizophrenia who fail to respond adequately to standard antipsychotic treatment. It has demonstrated superior efficacy in treating both the positive and negative symptoms in treatment-refractory cases. It also has the added benefit of causing minimal extrapyramidal side- effects, producing no tardive dyskinesia and having little effect on prolactin levels

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