Serum Level Measurements Optimize Aripriprazole Treatment in Adolescent Patients

2019 ◽  
Vol 47 (3) ◽  
pp. 261-264 ◽  
Author(s):  
Jochen Gehrmann ◽  
Peter Götz Lampe
Keyword(s):  
Serum Level ◽  
Significant Variation ◽  
Second Generation ◽  
Serum Levels ◽  
First Episode Psychosis ◽  
First Episode ◽  
Off Label ◽  
Episode Psychosis ◽  
Second Generation Antipsychotic ◽  
Over Time

Abstract. 21 minors suffering from first-episode psychosis or related disorders were treated with the second-generation antipsychotic aripriprazole with serum levels being monitored over time. A significant variation of serum levels was observed in about half of the patients. Patients from Africa showed high levels of aripriprazole. In seven patients, i. e. ca. 35 % of the sample, aripriprazole treatment had to be stopped for various reasons. Therefore, serum levels of this antipsychotic (which in Germany is still considered off-label treatment before the age of 18) should be regularly monitored particularly in patients from Africa.

scholarly journals Anterior Hippocampal–Cortical Functional Connectivity Distinguishes Antipsychotic Naïve First-Episode Psychosis Patients From Controls and May Predict Response to Second-Generation Antipsychotic Treatment

2019 ◽  
Vol 46 (3) ◽  
pp. 680-689 ◽  
Author(s):  
Esther M Blessing ◽  
Vishnu P Murty ◽  
Botao Zeng ◽  
Jijun Wang ◽  
Lila Davachi ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Random Forest ◽  
Treatment Response ◽  
Second Generation ◽  
First Episode Psychosis ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
Episode Psychosis ◽  
Second Generation Antipsychotic ◽  
Cortical Regions

Abstract Background Converging evidence implicates the anterior hippocampus in the proximal pathophysiology of schizophrenia. Although resting state functional connectivity (FC) holds promise for characterizing anterior hippocampal circuit abnormalities and their relationship to treatment response, this technique has not yet been used in first-episode psychosis (FEP) patients in a manner that distinguishes the anterior from posterior hippocampus. Methods We used masked-hippocampal-group-independent component analysis with dual regression to contrast subregional hippocampal–whole brain FC between healthy controls (HCs) and antipsychotic naïve FEP patients (N = 61, 36 female). In a subsample of FEP patients (N = 27, 15 female), we repeated this analysis following 8 weeks of second-generation antipsychotic treatment and explored whether baseline FC predicted treatment response using random forest. Results Relative to HC, untreated FEP subjects displayed reproducibly lower FC between the left anteromedial hippocampus and cortical regions including the anterior cingulate and insular cortex (P < .05, corrected). Anteromedial hippocampal FC increased in FEP patients following treatment (P < .005), and no longer differed from HC. Random forest analysis showed baseline anteromedial hippocampal FC with four brain regions, namely the insular–opercular cortex, superior frontal gyrus, precentral gyrus, and postcentral gyrus predicted treatment response (area under the curve = 0.95). Conclusions Antipsychotic naïve FEP is associated with lower FC between the anterior hippocampus and cortical regions previously implicated in schizophrenia. Preliminary analysis suggests that random forest models based on hippocampal FC may predict treatment response in FEP patients, and hence could be a useful biomarker for treatment development.

Early intervention with second-generation antipsychotics in first-episode psychosis: results of an 8-week naturalistic study

2010 ◽  
Vol 4 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Richard C. Josiassen ◽  
Rita A. Shaughnessy ◽  
Dawn M. Filymer ◽  
Ann Marie Donohue ◽  
Margit Kacso ◽  
...  
Keyword(s):  
Early Intervention ◽  
Second Generation ◽  
First Episode Psychosis ◽  
First Episode ◽  
Naturalistic Study ◽  
Episode Psychosis ◽  
Second Generation Antipsychotics

The effect of second-generation antipsychotics on basal ganglia and thalamus in first-episode psychosis patients

2019 ◽  
Vol 29 (12) ◽  
pp. 1408-1418
Author(s):  
Auria Albacete ◽  
Carolina Makowski ◽  
M. Mallar Chakravarty ◽  
Ridha Joober ◽  
Ashok K. Malla ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Second Generation ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis ◽  
Second Generation Antipsychotics

scholarly journals Neuroactive Steroids in First-Episode Psychosis: A Role for Progesterone?

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Martino Belvederi Murri ◽  
Flaminia Fanelli ◽  
Uberto Pagotto ◽  
Elena Bonora ◽  
Federico Triolo ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Serum Levels ◽  
First Episode Psychosis ◽  
Neuroactive Steroids ◽  
First Episode ◽  
Positive Symptoms ◽  
Symptom Dimensions ◽  
Episode Psychosis ◽  
Male Patients ◽  
And Gender

Neuroactive steroids may play a role in the pathophysiology of psychotic disorders, but few studies examined this issue. We compared serum levels of cortisol, testosterone, dehydroepiandrosterone, and progesterone between a representative sample of first-episode psychosis (FEP) patients and age- and gender-matched healthy subjects. Furthermore, we analyzed the associations between neuroactive steroids levels and the severity of psychotic symptom dimensions. Male patients had lower levels of progesterone than controls (p=0.03). Progesterone levels were inversely associated with the severity of positive symptoms (p=0.007). Consistent with preclinical findings, results suggest that progesterone might have a role in the pathophysiology of psychotic disorders.

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