A preliminary naturalistic study of low-dose ketamine for depression and suicide ideation in the emergency department

2011 ◽  
Vol 26 (S2) ◽  
pp. 1607-1607 ◽  
Author(s):  
G.L. Larkin ◽  
A.L. Beautrais ◽  
R.R. Turelli ◽  
G. Sanacora ◽  
S. Powsner ◽  
...  
Keyword(s):  
Suicide Ideation ◽  
Rating Scale ◽  
Rapid Onset ◽  
Open Label ◽  
Young Mania ◽  
Brief Psychiatric Rating Scale ◽  
Kaplan Meier ◽  
Scale Scores ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale

BackgroundRapid-onset antidepressants could have important clinical impact if their benefits extended to ED patients. We examined preliminary feasibility, tolerability and efficacy of single-dose IV ketamine in depressed ED patients with suicide ideation (SI).MethodsFourteen depressed ED patients with SI received a single IV bolus of ketamine (0.2 mg/kg) over 1–2 minutes. Patients were monitored for 4 hours, then re-contacted daily for 10 days. Treatment response and time to remission were evaluated using the Montgomery-Asberg Depression Rating Scale (MADRS) and Kaplan Meier survival analysis, respectively.ResultsBrief Psychiatric Rating Scale and Young Mania Rating Scale scores transiently increased in two subjects, consistent with ketamine's cognitive/behavioral effects in other populations. Mean MADRS scores fell significantly from 40.4 (SEM:1.8) at baseline to 11.5 (2.2) at 240 minutes. Median time to MADRS score ≤10 was 80 minutes (Interquartile Range: 0.67–24 hours). Suicide ideation scores (MADRS item 10) decreased significantly from 3.9 (SEM:0.4) at baseline to 0.6 (SEM:0.2) at 40 minutes post-administration, with improvements sustained over 10 days.ConclusionsThese data provide preliminary, open-label support for the feasibility and efficacy of ketamine as a rapid-onset antidepressant in the ED.

An Open-Label Trial of Aripiprazole Monotherapy in Children and Adolescents with Bipolar Disorder

CNS Spectrums ◽  
2007 ◽  
Vol 12 (9) ◽  
pp. 683-689 ◽  
Author(s):  
Joseph Biederman ◽  
Eric Mick ◽  
Thomas Spencer ◽  
Robert Doyle ◽  
Gagan Joshi ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Rating Scale ◽  
Vital Signs ◽  
Pediatric Bipolar Disorder ◽  
Open Label ◽  
Young Mania ◽  
Double Blind ◽  
Scale Scores ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale

ABSTRACTIntroduction: Aripiprazole is a novel second-generation antipsychotic approved for the treatment of bipolar disorder in adults but there is no systematic data available in pediatric bipolar disorder.Methods: This was an 8-week, open-label, prospective study of aripiprazole 9.4±4.2 mg/day monotherapy to assess the efficacy and tolerability of this compound in treating pediatric bipolar disorder. Assessments included the Young Mania Rating Scale, Clinical Global Impressions-Improvement scale, and Brief Psychiatric Rating Scale. Adverse events were assessed through spontaneous self-reports, vital signs weight monitoring, and laboratory analysis.Results: Fifteen of the 19 bipolar youth (79%) completed the study. Aripiprazole treatment was associated with clinically and statistically significant improvement in mean Young Mania Rating Scale scores (−18.0±6.9, P<.0001). With the important exception of two cases of extrapyramidal symptoms that precipitated dropout, aripiprazole was well tolerated with no statistically significant increase in body weight (1.8±1.7 kg, P=.2).Conclusion: Open-label aripiprazole treatment was beneficial in the treatment of mania in youth with bipolar disorder. Future placebo-controlled, double blind studies are warranted.

Study of the Clinical Utility of Radioreceptor Assay in Outpatients with Schizophrenia Receiving High Doses of Neuroleptics

1993 ◽  
Vol 38 (8) ◽  
pp. 534-540 ◽  
Author(s):  
Marie-A. Gagné ◽  
Hugues Cormier ◽  
Gérard Leblanc ◽  
Daniel Lévesque ◽  
Thérèse Di Paolo
Keyword(s):  
Plasma Levels ◽  
Rating Scale ◽  
Radioreceptor Assay ◽  
High Dose ◽  
Progressive Reduction ◽  
Brief Psychiatric Rating Scale ◽  
Scale Scores ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
High Doses

A radioreceptor assay (RRA) was used to determine the neuroleptic plasma levels of 32 outpatients with schizophrenia receiving a high dose of neuroleptics (the equivalent of 18 mg or more of oral haloperidol per day) and undergoing a 50% partial and progressive reduction (ten percent each month for five months) in their medication. Plasma levels of neuroleptics were measured three times: before (T1) and immediately after the 50% reduction (T2) and five months later (T3). A linear correlation was observed between neuroleptic plasma levels obtained by RRA and the neuroleptic doses prescribed at T1 and T3. Furthermore, neuroleptic plasma levels were significantly lower at T3 than at T1. Concurrent evaluations of psychopathology were done using the Brief Psychiatric Rating Scale, and the results indicated that no correlation exists between neuroleptic plasma levels and the total rating scale scores at T1 but a significant correlation was observed at T3.

scholarly journals Does the efficacy of asenapine in bipolar disorder increase in the presence of comorbidity with a substance use disorder? A naturalistic study

2016 ◽  
Vol 7 (2) ◽  
pp. 67-77 ◽  
Author(s):  
Sergio De Filippis ◽  
Ilaria Cuomo ◽  
Georgios D. Kotzalidis ◽  
Daniela Pucci ◽  
Pietro Zingaretti ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Substance Use ◽  
Substance Use Disorder ◽  
Repeated Measures ◽  
Rating Scale ◽  
Type I ◽  
Open Label ◽  
Young Mania ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale

Background: Asenapine is a second-generation antipsychotic approved in Europe for treating moderate-to-severe manic episodes in adults affected by type I bipolar disorder (BD-I). We aimed to compare its efficacy in psychiatric inpatients with BD-I, with or without substance use disorder (SUD). Methods: We administered flexible asenapine doses ranging from 5–20 mg/day to 119 voluntarily hospitalized patients with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) BD-I diagnosis, with or without SUD. Patients were assessed with clinician-rated questionnaires [i.e. Brief Psychiatric Rating Scale (BPRS), Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), and Global Assessment of Functioning (GAF)]. Assessments were carried out at baseline (T0, prior to treatment), and 3 (T1), 7 (T2), 15 (T3), and 30 days (T4) after starting treatment for all clinical scales and at T0 and T4 for the GAF. Results: Patients improved on all scales ( p < 0.001) across all timepoints, as shown both by paired-sample comparisons and by applying a repeated-measures, generalized linear model (GLM). Patients without comorbid SUD showed greater reductions in BPRS scores at T2 and T3, greater reduction in YMRS scores at T3, and lower HARS scores at all timepoints. HDRS scores did not differ between the two groups at any timepoint. However, the reduction in HARS scores in the comorbid group was stronger than in the BD-I only group, albeit not significantly. Side effects were few and mild-to-moderate. Conclusions: The open-label design and the relatively short observation period may expose to both type I and type II statistical errors (false positive and false negatives). Asenapine showed effectiveness and safety in hospitalized BD-I patients. Its effect was stronger in patients without comorbid SUD.

The Life Skills Profile: A Study of Its Psychometric Properties

1995 ◽  
Vol 29 (3) ◽  
pp. 492-499 ◽  
Author(s):  
Thomas Trauer ◽  
Robert A. Duckmanton ◽  
Edmond Chiu
Keyword(s):  
Psychometric Properties ◽  
Mental Health Professionals ◽  
Life Skills ◽  
Rating Scale ◽  
Confirmatory Factor Analyses ◽  
Brief Psychiatric Rating Scale ◽  
Scale Scores ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Level Scale

Two hundred patients with severe mental illness of mixed type were assessed by treating mental health professionals a total of 730 times with the Life Skills Profile (LSP). Confirmatory factor analyses broadly confirmed the existence of the Self-care and Non-turbulence subscales. Internal consistencies were generally good but inter-rater reliabilities were of only marginal acceptability. The fit of the data to the five subscales can be improved by reassigning two items. The Communication subscale had the poorest psychometric properties. Certain LSP scale scores were found to vary with how well and how long the rater had known the patient. Validity, which was assessed by relating LSP scores to locus of care (i.e. community or hospital), Brief Psychiatric Rating Scale (BPRS) ratings and Resource Associated Functional Level Scale (RAFLS) ratings, was good. An alternative scoring system yielded rather clearer meaning for some of the subscales.

Validation of an MMPI Short Form with Literate and Illiterate Patients

1989 ◽  
Vol 64 (1) ◽  
pp. 327-336 ◽  
Author(s):  
Elizabeth A. Dillon ◽  
L. Charles Ward
Keyword(s):  
Rating Scale ◽  
Short Form ◽  
Clinical Correlates ◽  
Brief Psychiatric Rating Scale ◽  
Scale Scores ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Good Substitute

An Improved Readability Form (IRF) of the MMPI was orally administered to 100 literate and 119 illiterate patients, and 140 literate patients were given the full MMPI with standard instructions. Profile comparisons of the MMPI with the IRF given to literates or extracted from the full MMPI yielded only small differences. The much larger differences in the IRF profiles of the illiterates were removed by controlling statistically for sex, race, age, and education. The IRF, when given to literate patients, was a good substitute for the full MMPI in predicting Brief Psychiatric Rating Scale scores. For the illiterates, the two most salient relationships with scores on the Brief Psychiatric Rating Scale were preserved, but several weaker associations were qualitatively altered. When the IRF is administered to illiterate patients, the pattern of clinical correlates may differ from those obtained with literate patients given the IRF or MMPI.

scholarly journals Olanzapine in practice: a prospective naturalistic study

1999 ◽  
Vol 23 (3) ◽  
pp. 178-180 ◽  
Author(s):  
David Taylor ◽  
Shameem Mir ◽  
Shubra Mace
Keyword(s):  
Beneficial Effect ◽  
Rating Scale ◽  
Clinical Implications ◽  
Naturalistic Study ◽  
Schizophrenic Psychosis ◽  
Brief Psychiatric Rating Scale ◽  
Scale Scores ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale

Aims and methodThe study aimed to evaluate the effectiveness of the naturalistic use of olanzapine. Prescribers of olanzapine were asked to provide baseline and six-week Brief Psychiatric Rating Scale scores for 56 in-patients. Withdrawals from treatment were also noted.ResultsOlanzapine was not effective in any of the 12 patients with refractory schizophrenia and four patients worsened. In 36 patients with non-refractory schizophrenia, 16 (44%) improved and 10 (28%) were categorised as treatment failures. of eight patients with non-schizophrenic psychosis, only one improved and two were treatment failures.Clinical implicationsOlanzapine is effective in treating non-refractory schizophrenia, but appears to have no beneficial effect in refractory schizophrenia.

scholarly journals Clinical implications of Brief Psychiatric Rating Scale scores

2005 ◽  
Vol 187 (4) ◽  
pp. 366-371 ◽  
Author(s):  
Stefan Leucht ◽  
John M. Kane ◽  
Werner Kissling ◽  
Johannes Hamann ◽  
Eva Etschel ◽  
...  
Keyword(s):  
Rating Scale ◽  
Clinical Implications ◽  
Positive Symptoms ◽  
Percentage Reduction ◽  
Drug Trials ◽  
Brief Psychiatric Rating Scale ◽  
Scale Scores ◽  
Psychiatric Rating ◽  
Clinical Meaning ◽  
Psychiatric Rating Scale

BackgroundDespite the widespread use of the Brief Psychiatric Rating Scale (BPRS), the clinical meaning of its total score and cut-off values used to define treatment response are unclear.AimsTo link the BPRS to Clinical Global Impression (CGI) ratings.MethodEquipercentile linking of BPRS and CGI ratings from seven drug trials in acutely ill patients with schizophrenia (n=1979).Results‘Mildly ill’ according to the CGI approximately corresponded to a BPRS total score of 31, ‘moderately ill’ to a BPRS score of 41 and ‘markedly ill’ to a BPRS score of 53. ‘Minimally improved’ according to the CGI score was associated with percentage BPRS reductions of 24, 27 and 30% at weeks 1, 2 and 4, respectively. The corresponding numbers for a CGI rating of ‘much improved’ were 44, 53 and 58%ConclusionsThe results provide a clearer understanding of how to interpret BPRS total and percentage reduction scores in clinical trials with patients acutely ill with schizophrenia who are experiencing positive symptoms.

Inter- and Intra-Rater Reliability of the Brief Psychiatric Rating Scale

1973 ◽  
Vol 33 (3) ◽  
pp. 783-792 ◽  
Author(s):  
Abraham Flemenbaum ◽  
Robert L. Zimmermann
Keyword(s):  
Rating Scale ◽  
Clinical Psychologists ◽  
Rater Reliability ◽  
Psychiatric Residents ◽  
Professional Groups ◽  
Brief Psychiatric Rating Scale ◽  
Single Scale ◽  
Scale Scores ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale

Video-taped interviews and mock ratings of typical cases were employed to evaluate raters' consistency of 37 raters (14 staff psychiatrists, 11 psychiatric residents, 10 clinical psychologists and interns, 2 nurses). Total score across time was most stable, single scale scores least consistent. Trends between professional groups were not large and not always related to degree of training, but psychologists rated typical patients more consistently, psychiatric residents showed greater across-time and inter-rater consistency. The latter varied on taped interviews with symptoms being rated. Over-all, reliabilities on the Brief Psychiatric Rating Scale were as high as could be expected.

Self-Induced Water Intoxication Treated with Risperidone

1996 ◽  
Vol 41 (10) ◽  
pp. 648-650 ◽  
Author(s):  
Richard C Millson ◽  
Craig E Emes ◽  
William G Glackman
Keyword(s):  
Rating Scale ◽  
Chronic Schizophrenia ◽  
Water Intoxication ◽  
Open Label ◽  
Open Label Study ◽  
Chronic Group ◽  
Brief Psychiatric Rating Scale ◽  
Significant Efficacy ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale

Objective: To determine whether or not risperidone is efficacious in treating self-induced water intoxication in patients with chronic schizophrenia. Method: We carried out a prospective 11-month open-label study using risperidone to treat 8 men with chronic schizophrenia and self-induced water intoxication. Results: The 8 men were not able to reduce their fluid consumption compared with their baseline intake. Risperidone, however, significantly decreased the Brief Psychiatric Rating Scale (BPRS) scores of this very chronic group. Conclusions: Although risperidone decreased schizophrenic symptoms, it did not have significant efficacy in treating self-induced water intoxication. This study may have implications for the treatment of addictive behaviour.

Zuclopenthixol, D1/D2 antagonist, for treatment of chronic aggressive schizophrenia and psychotic oligophrenic patients

1998 ◽  
Vol 13 (5) ◽  
pp. 273-275 ◽  
Author(s):  
A Grinshpoon ◽  
M Moskowitz ◽  
A Valevski ◽  
A Kreizman ◽  
L Palei ◽  
...  
Keyword(s):  
Scale Score ◽  
Rating Scale ◽  
Open Label ◽  
Brief Psychiatric Rating Scale ◽  
Psychiatric Rating ◽  
D2 Antagonist ◽  
Open Label Trial ◽  
Psychiatric Rating Scale ◽  
Psychiatric Department ◽  
Zuclopenthixol Decanoate

SummaryAn open label trial was conducted to study the efficacy of zuclopenthixol decanoate, a D1/D2 antagonist, in the treatment of chronic (> 10 years) neuroleptic-resistant aggressive schizophrenia (n = 10) and psychotic oligophrenic patients (n = 6). A significant reduction was noted in the Brief Psychiatric Rating Scale score, especially in the clusters of hostility-suspiciousness and excitement. After many years of seclusion, ten of the 16 patients were transferred to an open psychiatric department and were allowed to visit their families.

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