Old drugs vs. new drugs: Treating bipolar disorder in children and adolescents

2011 ◽  
Vol 26 (S2) ◽  
pp. 277-277
Author(s):  
P.T. Dineen ◽  
A.L. Malizia
Keyword(s):  
Bipolar Disorder ◽  
Literature Review ◽  
Children And Adolescents ◽  
Pharmacological Treatment ◽  
Antipsychotic Drugs ◽  
Second Generation ◽  
New Drugs ◽  
Limited Evidence ◽  
Second Generation Antipsychotics ◽  
Old Drugs

This is a literature review of the evidence for pharmacological treatment for bipolar disorder in children and adolescents. The review covers drugs that have controlled studies and is divided into older, classical antimanic drugs and the newer mood-stabliser/antipsychotic drugs. The drugs that have had controlled studies are aripiprazole, lithium, olanzapine, oxcarbazepine, quetiapine, risperidone, topiramate, valproate/divalproex drugs and ziprasidone. Carbamazepine, lamotrigine and nefazodone (which is included for completion) were not found to have any evidence from controlled studies. Of the 9 drugs that have evidence, it was found that the newer second-generation antipsychotics had better evidence for efficacy for management of acute mania in children and adolescents: aripiprazole, risperidone, quetiapine and olanzapine. Classical antimanic agents such as lithium and valproate-based drugs had limited evidence.

The use of second generation antipsychotics in children and adolescents with bipolar disorder and schizophrenia: A summary of the AHRQ comparative effectiveness review

2013 ◽  
Vol 2 (11) ◽  
pp. 350-352
Author(s):  
Jeani Pulsipher ◽  
Gary M. Levin
Keyword(s):  
Bipolar Disorder ◽  
Adverse Effects ◽  
Children And Adolescents ◽  
Mood Disorders ◽  
Comparative Effectiveness ◽  
Second Generation ◽  
Pediatric Patients ◽  
Healthcare Research ◽  
Second Generation Antipsychotics

Second generation antipsychotics (SGAs) can be effective in treating mood disorders in pediatric patients; however, these medications also present with a risk of serious adverse effects. A recent review by the Agency for Healthcare Research and Quality (AHRQ) evaluated the use of SGAs in pediatric patients. This article summarizes the findings of the review, with a focus on bipolar disorder and schizophrenia.

Eine Stellungnahme zur Debatte über die „atypischen“ Antipsychotika

2010 ◽  
Vol 07 (01) ◽  
pp. 11-17
Author(s):  
A. Schmied ◽  
W. Kissling ◽  
J. M. Davis ◽  
S. Leucht
Keyword(s):  
Antipsychotic Drugs ◽  
Second Generation ◽  
Cost Utility ◽  
First Episode ◽  
Intervention Effectiveness ◽  
Second Generation Antipsychotics ◽  
First Episode Schizophrenia

ZusammenfassungSeit etwa zehn Jahren gibt es eine kontrovers geführte Debatte über die Antipsychotika der zweiten Generation („second generation antipsychotics“, SGA) in der Schizophreniebehandlung, die in der Publikation der sogenannten Effektivitätsstudien CATIE (Clinical Antipsychotic Trial of Intervention Effectiveness), CUtLASS (Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study) und EUFEST (European First-Episode Schizophrenia Trial) gipfelte. In der vorliegenden Übersicht fassen wir die Ergebnisse dreier aktueller systematischer Reviews zusammen, in denen die Antipsychotika der zweiten Generation (SGAs) mit Placebo, mit konventionellen Antipsychotika oder direkt miteinander verglichen wurden. Wir stellen die Metaanalysen in den Kontext anderer systematischer Reviews und beleuchten sie vor dem Hintergrund von CATIE, CUtLASS und EUFEST. Unserer Meinung nach sind viele Ergebnisse konsistent, sie werden aber von verschiedenen Experten und Interessensvertretern unterschiedlich interpretiert. Die Daten zeigen, dass SGAs keine homogene Gruppe darstellen und dass diese eher verwirrende Einteilung aufgegeben werden sollte. Unserer Meinung nach stellen die SGAs nicht den Durchbruch dar, den die Industrie gerne sehen würde. Ihre unterschiedlichen Eigenschaften erlauben aber eine bessere Ausrichtung des Behandlungsplans an den Problemen des individuellen Patienten. Diese Medikamente haben die Behandlungspalette deutlich erweitert und die meisten Psychiater, ganz zu schweigen von den Patienten, würden wohl nur sehr ungerne auf diese Präparate verzichten wollen.

scholarly journals New antipsychotic drugs for the treatment of agitation and psychosis in Alzheimer’s disease: focus on brexpiprazole and pimavanserin

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 686 ◽  
Author(s):  
Filippo Caraci ◽  
Mario Santagati ◽  
Giuseppe Caruso ◽  
Dario Cannavò ◽  
Gian Marco Leggio ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Receptor Antagonist ◽  
Safety Profile ◽  
Antipsychotic Drugs ◽  
Second Generation ◽  
Phase Iii ◽  
Second Generation Antipsychotics ◽  
Recent Phase

Behavioral and psychological symptoms of dementia are symptoms of disturbed perception, mood, behavior, and thought content that occurred frequently. These symptoms, which include apathy, depression, anxiety, psychosis, agitation, and aggression, can serve as predictors of and early clinical diagnostic markers for Alzheimer’s disease (AD) and are common precipitants of institutional care. Agitation and psychosis are associated with accelerated disease progression and increased tau phosphorylation in patients with AD. Current guidelines recommend the use of second-generation antipsychotics for the treatment of agitation and psychosis in AD, but only after first-line non-pharmacological interventions and for no longer than 12 weeks because long-term use of these drugs is associated with an increased risk of mortality and an increased frequency of cerebrovascular events. Therefore, new antipsychotic drugs with improved efficacy and safety are needed as an alternative to current antipsychotic drugs. In this report, we discuss some of the most relevant advances in the field of agitation and psychosis in AD and focus on the recent positive clinical evidence observed with two new antipsychotics drugs: brexpiprazole and pimavanserin. Brexpiprazole is a receptor partial agonist (D2, D3, 5-HT1A), receptor antagonist (5-HT2A/B, α1B/α2C) according to the neuroscience-based nomenclature. Two recent phase III clinical trials have shown that brexpiprazole 2 mg/day is effective for the treatment of agitation in patients with AD and has an improved tolerability and safety profile compared with currently available second-generation antipsychotics. Pimavanserin is a receptor antagonist (5-HT2A, 5-HT2C) that has been given market authorization for psychosis occurring in Parkinson’s disease. Recent phase II studies suggest that this drug is effective in AD patients with more severe psychosis, although further long-term studies are needed to better define the efficacy and long-term safety profile of pimavanserin for the treatment of psychosis in AD.

scholarly journals The incidence, psychiatric co-morbidity and pharmacological treatment of severe mental disorders in children and adolescents

2018 ◽  
Vol 49 ◽  
pp. 16-22 ◽  
Author(s):  
Ragnar Nesvåg ◽  
Jørgen G. Bramness ◽  
Marte Handal ◽  
Ingeborg Hartz ◽  
Vidar Hjellvik ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Children And Adolescents ◽  
Pharmacological Treatment ◽  
Depressive Episode ◽  
Psychotic Symptoms ◽  
Severe Mental Disorder ◽  
Co Morbidity ◽  
First Time

AbstractBackgroundAntipsychotic drug use among children and adolescents is increasing, and there is growing concern about off-label use and adverse effects. The present study aims to investigate the incidence, psychiatric co-morbidity and pharmacological treatment of severe mental disorder in Norwegian children and adolescents.MethodsWe obtained data on mental disorders from the Norwegian Patient Registry on 0–18 year olds who during 2009–2011 were diagnosed for the first time with schizophrenia-like disorder (International Classification of Diseases, 10th revision codes F20-F29), bipolar disorder (F30-F31), or severe depressive episode with psychotic symptoms (F32.3 or F33.3). Data on filled prescriptions for psychotropic drugs were obtained from the Norwegian Prescription Database.ResultsA total of 884 children and adolescents (25.1 per 100 000 person years) were first time diagnosed with schizophrenia-like disorder (12.6 per 100 000 person years), bipolar disorder (9.2 per 100 000 person years), or severe depressive episode with psychotic symptoms (3.3 per 100 000 person years) during 2009–2011. The most common co-morbid mental disorders were depressive (38.1%) and anxiety disorders (31.2%). Antipsychotic drugs were prescribed to 62.4% of the patients, 72.0% of the schizophrenia-like disorder patients, 51.7% of the bipolar disorder patients, and 55.4% of the patients with psychotic depression. The most commonly prescribed drugs were quetiapine (29.5%), aripiprazole (19.6%), olanzapine (17.3%), and risperidone (16.6%).ConclusionsWhen a severe mental disorder was diagnosed in children and adolescents, the patient was usually also prescribed antipsychotic medication. Clinicians must be aware of the high prevalence of depressive and anxiety disorders among early psychosis patients.

Obsessive-Compulsive Symptoms in Schizophrenia

2017 ◽  
Author(s):  
Michael Poyurovsky
Keyword(s):  
Longitudinal Studies ◽  
Obsessive Compulsive Disorder ◽  
Pharmacological Treatment ◽  
Patient Population ◽  
Second Generation ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder ◽  
Second Generation Antipsychotics ◽  
Psychological Studies

This chapter evidence for a relationship between obsessive-compulsive disorder and psychosis, in some patients. Obsessive-compulsive symptoms are common in individuals with schizophrenia; this ‘schizo-obsessional’ population has been relatively little studied and presents marked clinical challenges. Longitudinal studies suggest that OC symptoms precede psychosis in some patients but develop later in illness in others; they can be induced by some second-generation antipsychotics. Neurobiological and cognitive psychological studies suggest that schizo-obsessional patients have greater impairment in several domains than those with schizophrenia or OC symptoms alone. The literature on pharmacological treatment of this patient population, which is limited, is review.

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