Do antiserotonergic antipsychotics induce OCD more frequently than first-generation antipsychotics in the long-term treatment of schizophrenia?

Bipolar disorder (BD) is a recurrent and often chronic condition that is characterized by episodes of mania, hypomania, depression, and mixed affective states. BD affects up to 5% of the population, ranks sixth as a cause of worldwide disability among persons 15 to 44 years old, and has an estimated lifetime suicide rate of 10–20%. Pharmacotherapy remains one of the most important interventions for initial and long-term treatment of BD. In this chapter, pharmacological interventions for acute manic episodes, for acute depressive episodes, and for the prevention of recurrent affective episodes of either type are systematically presented, with special emphasis on the use of first-generation and second-generation mood-stabilizing drugs and antidepressant drugs. Special issues related to pharmacotherapy of BD are also discussed such as rapid cycling BD, mixed affective states, psychiatric comorbidity, and pregnancy and the postpartum period.

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Clinical guideline recommendations for antipsychotic long-acting injections

The British Journal of Psychiatry ◽

10.1192/bjp.195.52.s63 ◽

2009 ◽

Vol 195 (S52) ◽

pp. s63-s67 ◽

Cited By ~ 77

Author(s):

John M. Kane ◽

Carlos Garcia-Ribera

Keyword(s):

First Generation ◽

Term Treatment ◽

First Episode ◽

Patterns Of Use ◽

Episode Psychosis ◽

Long Term Treatment ◽

Long Acting ◽

Over 40 Years ◽

Subsequent Relapse

BackgroundLong-acting injections (LAIs) of antipsychotic drugs were developed over 40 years ago in an attempt to improve the long-term treatment of schizophrenia.AimsTo review existing guidelines concerning antipsychotic use generally, and LAIs in particular, and how patients might be identified as potential candidates for LAI treatment.MethodLiterature review.ResultsCurrently several first-generation and one second-generation antipsychotic LAIs are available, with others under development. Although the use of LAIs is widespread around the world, patterns of use vary widely. Important considerations regarding the use of LAIs include the indications for long-term pharmacotherapy in schizophrenia in general, the indications for LAIs, the risks associated with LAIs, the need to update guidelines and the issue of cost.ConclusionsThe use of these injections in first-episode psychosis and treatment-refractory schizophrenia is not currently a focus of recommendations, but should be considered. Long-acting injections remain an underutilised option in many countries despite frequent non-adherence with oral medication and subsequent relapse.

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CS06-04 - Short and long-term treatment outcomes in schizophrenia

European Psychiatry ◽

10.1016/s0924-9338(11)73493-9 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1789-1789

Author(s):

H.-J. Moeller

Keyword(s):

First Generation ◽

Term Treatment ◽

Receptor Imaging ◽

High Expectations ◽

Chronic Disorder ◽

Second Generation Antipsychotics ◽

Long Term Treatment ◽

Schizophrenic Patients ◽

Short And Long Term

Schizophrenia is a chronic disorder with a high risk of poor outcome in terms of symptoms and social functioning and possibly also progressive brain alterations. The relapse rate is high and each relapse can induce further aggravations, both in psychosocial as well as in neurobiological terms. Thus, acute and long-term treatment with the highest degree of effectiveness should be provided to the patients in acute and long-term treatment.Neuroleptic medication is the most important part of the treatment regimen for schizophrenic patients. The efficacy of neuroleptics in the acute and long-term treatment of schizophrenia is very well proven and the effect size is comparatively high. The second-generation antipsychotics (SGAs) have advantages over the neuroleptics of the first-generation (FGAs), and high expectations have therefore been put into them for the treatment of schizophrenia. Their better extrapyramidal-motor tolerability and efficacy in treating negative, depressive and cognitive symptoms, in addition to positive symptoms, supposedly result in a more favourable influencing of the overall course of the disease and in a higher quality of life for the patients, thus improving their acceptance by patients and leading to increased compliance. Differences in the pharmacological profile can be identified among others by receptor imaging approaches.

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