scholarly journals Psychopharmacology and adverse effects of antipsychotic long-acting injections: A review

2009 ◽  
Vol 195 (S52) ◽  
pp. s13-s19 ◽  
Author(s):  
David Taylor
Keyword(s):  
Weight Gain ◽  
Adverse Effects ◽  
Movement Disorders ◽  
First Generation ◽  
Second Generation ◽  
High Rate ◽  
Metabolic Effects ◽  
Using Data ◽  
Long Acting ◽  
First And Second Generation

BackgroundDepot antipsychotics are widely used in clinical practice. Long-acting formulations of second-generation antipsychotics are now being developed and introduced.AimsTo review the pharmacology, pharmacokinetics and adverse effect profiles of currently available antipsychotic long-acting injections (LAIs).MethodThe psychopharmacological properties of first- and second-generation antipsychotic LAIs are reviewed using data available up to October 2008.ResultsFirst-generation antipsychotic (FGA) LAIs are associated with a high rate of acute and chronic movement disorders. Risperidone LAI is better tolerated in this respect, but is associated with hyperprolactinaemia and weight gain. Olanzapine LAI causes weight gain and other metabolic effects but appears not to be associated with an important incidence of movement disorders.ConclusionsDosing of LAIs is complicated by delayed release of drug, changes in plasma levels without change in dose, and by the lack of data establishing clear dose requirements. All LAIs offer the prospect of assured adherence (although patients may still default on treatment) but their use is complicated by adverse effects, complex pharmacokinetics and confusion over dose–response relationships.

scholarly journals Educational Assimilation of First-Generation and Second-Generation Immigrants in Germany

2021 ◽  
Author(s):  
Thomas Gries ◽  
Margarete Redlin ◽  
Moonum Zehra
Keyword(s):  
First Generation ◽  
Second Generation ◽  
First Generation Immigrants ◽  
Language And Culture ◽  
Mena Countries ◽  
Education Outcomes ◽  
Second Generation Immigrants ◽  
Using Data ◽  
Education Gap ◽  
First And Second Generation

AbstractUsing data from the German Socio-Economic Panel for 1984–2018, we analyze the intergenerational education mobility of immigrants in Germany by identifying the determinants of differences in educational stocks for first- and second-generation immigrants in comparison to individuals without a migration background. Our results show that on average, first-generation immigrants have fewer years of schooling than native-born Germans and have a disproportionate share of lower educational qualifications. This gap is strongly driven by age at immigration, with immigration age and education revealing a nonlinear relationship. While the gap is relatively small among individuals who migrate at a young age, integrating in the school system at secondary school age leads to large disadvantages. Examining the educational mobility of immigrants in Germany, we identify an inter-generational catch-up in education. The gap in education between immigrants and natives is reduced for the second generation. Finally, we find that country of origin differences can account for much of the education gap. While immigrants with an ethnic background closer to the German language and culture show the best education outcomes, immigrants from Turkey, Italy, and other southern European countries and especially the group of war refugees from Syria, Afghanistan, Iraq and other MENA countries, have the lowest educational attainment.

scholarly journals Pharmacologic treatment of schizophrenia

2010 ◽  
Vol 12 (3) ◽  
pp. 345-357 ◽  
Keyword(s):  
Adverse Effects ◽  
First Generation ◽  
Second Generation ◽  
Treatment Options ◽  
Patient Choice ◽  
Acute Response ◽  
Augmentation Strategies ◽  
Second Generation Antipsychotics ◽  
New Treatment ◽  
First And Second Generation

Despite pharmacologic advances, the treatment of schizophrenia remains a challenge, and suboptimal outcomes are still all too frequent. Although treatment goals of response, remission, and recovery have been defined more uniformly, a good "effectiveness" measure mapping onto functional outcomes is still lacking. Moreover, the field has to advance in transferring measurement-based approaches from research to clinical practice. There is an ongoing debate whether, and which, first- or second-generation antipsychotics should be used. However an individualized treatment approach needs to consider current symptoms, comorbid conditions, past therapeutic response, and adverse effects, as well as patient choice and expectations. Moreover acute and long-term goals and effects of medication treatment need to be balanced. While the acute response to appropriately dosed first-generation antipsychotics may not differ much from second-generation antipsychotics, advantages of lower rates of extrapyramidal side effects, tardive dyskinesia, and, possibly, relapse may favor second-generation antipsychotics. However when considering individual adverse effect profiles, the differentiation into first- and second-generation antipsychotics as unified classes can not be upheld, and a more differentiated view and treatment selection is required. To date, clozapine is the only evidence-based treatment for refractory patients, and the role of antipsychotic polypharmacy and other augmentation strategies remains unclear, at best. To improve the treatment outcomes in schizophrenia, research efforts are needed that elucidate biomarkers of the illness and of treatment response (both therapeutic and adverse effects). Moreover, new treatment options are needed that affect nondopaminergic targets with relevance for symptom reduction, relapse prevention, enhanced efficacy for nonresponders, and reduced key adverse effects.

scholarly journals Second-Generation Antipsychotics and Extrapyramidal Adverse Effects

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Nevena Divac ◽  
Milica Prostran ◽  
Igor Jakovcevski ◽  
Natasa Cerovac
Keyword(s):  
Adverse Effects ◽  
First Generation ◽  
Second Generation ◽  
Great Expectations ◽  
Extrapyramidal Syndrome ◽  
Generation Agent ◽  
Second Generation Antipsychotics ◽  
History Of ◽  
High Doses ◽  
First And Second Generation

Antipsychotic-induced extrapyramidal adverse effects are well recognized in the context of first-generation antipsychotic drugs. However, the introduction of second-generation antipsychotics, with atypical mechanism of action, especially lower dopamine receptors affinity, was met with great expectations among clinicians regarding their potentially lower propensity to cause extrapyramidal syndrome. This review gives a brief summary of the recent literature relevant to second-generation antipsychotics and extrapyramidal syndrome. Numerous studies have examined the incidence and severity of extrapyramidal syndrome with first- and second-generation antipsychotics. The majority of these studies clearly indicate that extrapyramidal syndrome does occur with second-generation agents, though in lower rates in comparison with first generation. Risk factors are the choice of a particular second-generation agent (with clozapine carrying the lowest risk and risperidone the highest), high doses, history of previous extrapyramidal symptoms, and comorbidity. Also, in comparative studies, the choice of a first-generation comparator significantly influences the results. Extrapyramidal syndrome remains clinically important even in the era of second-generation antipsychotics. The incidence and severity of extrapyramidal syndrome differ amongst these antipsychotics, but the fact is that these drugs have not lived up to the expectation regarding their tolerability.

Assimilation of the Puerto Ricans on the Mainland

1968 ◽  
Vol 2 (2) ◽  
pp. 21-39
Author(s):  
John J. Macisco
Keyword(s):  
United States ◽  
First Generation ◽  
Second Generation ◽  
Puerto Ricans ◽  
The United States ◽  
Social Scientists ◽  
First Marriage ◽  
Labor Force Status ◽  
Age At First Marriage ◽  
First And Second Generation

Social scientists have repeatedly tried to specify the process whereby assimilation takes place. This article points out the value of socio-demographic analysis in the study of assimilation, by describing the characteristics of Puerto Ricans on the United States mainland. In order to assess the direction of change between the first and second generation Puerto Ricans, data for the total United States population are also presented. Most of the data are drawn from the 1960 Census. First generation Puerto Ricans are compared with the second generation along the following dimensions: age, education, labor force status, income, occupation, age at first marriage, percent outgroup marriage and fertility. The Author concludes that second generation Puerto Ricans are moving in the direction of total United States averages.

scholarly journals First-generation versus second-generation long-acting injectable antipsychotic drugs and time to relapse

2018 ◽  
Vol 8 (12) ◽  
pp. 333-336 ◽  
Author(s):  
James M. Stone ◽  
Simon Roux ◽  
David Taylor ◽  
Paul D. Morrison
Keyword(s):  
First Generation ◽  
Antipsychotic Drugs ◽  
Second Generation ◽  
Patient Acceptability ◽  
Inpatient Ward ◽  
Medication Discontinuation ◽  
Kaplan Meier ◽  
The Difference ◽  
Long Acting ◽  
Time To Relapse

Background: The development of long-acting injectable formulations (LAIs) of second-generation antipsychotic drugs (SGAs) has been suggested as having advantage over first-generation antipsychotic (FGA) LAIs. In this study, we investigated the hypothesis that there was a longer time to relapse in patients with schizophrenia started on SGA LAI versus FGA LAI. Methods: Patients with a diagnosis of schizophrenia or schizoaffective disorder who were started on an SGA LAI while on an inpatient ward were identified through searching of the anonymised historical medical records at the South London and Maudsley NHS Foundation Trust. Patients starting FGA LAIs matched for diagnosis, age and date of hospital admission were identified. Time to readmission, discontinuation of LAI or death were identified. Kaplan–Meier plots were generated for each group, and the difference between groups analysed using log-rank methods. Results: There were 157 patients identified in each group. There was no difference in time to readmission, medication discontinuation or death in patients on SGA LAI versus FGA LAI. Conclusions: We found no evidence of advantage in terms of maintaining response in SGA LAI versus FGA LAI. Prescriber choice should be guided by other factors such as side-effect profile, patient acceptability and price.

scholarly journals Why do first and second-generation young migrants volunteer? The Migrant Volunteerism Motivation Model (MVMM)

2019 ◽  
Vol 7 (2) ◽  
pp. 1089-1107 ◽  
Author(s):  
Sara Alfieri ◽  
Daniela Marzana ◽  
Sara Martinez Damia
Keyword(s):  
Transition To Adulthood ◽  
Process Model ◽  
First Generation ◽  
Second Generation ◽  
Maintenance Phase ◽  
Structured Interviews ◽  
Sub Saharan ◽  
Italian Context ◽  
First And Second Generation ◽  
Motivation Model

The following study aims at inquiring into the motivations behind young migrants’ volunteerism in civic organizations in Italy, namely in starting and maintaining their engagement (preliminary vs. maintenance phase). The term “young migrants” refers to first and second generation of migrants who deal with two challenges: the transition to adulthood and the acquisition of a cultural identity. We conducted semi-structured interviews with 37 Sub-Saharan young migrants living in Italy (18-32 years old), 19 of first generation (1G) and 18 of second generation (2G). The Omoto and Snyder’s Volunteer Process Model (VPM, 1995) was used as an underpinning theoretical framework and a guide for the interpretations of the results. The findings indicate that a) motivations included in the VPM are also found for young migrants, b) some of these motivations take particular meaning for young migrants, c) some motivations are not included in the VPM and are specific of this sample. We named these last motivations: social norms, advocacy and ethno-cultural. In addition, some considerations may be advanced regarding the generation and the phase of motivation: 1G migrants are particularly moved by the importance of integration in the Italian context and by the promotion of their ethnic group while 2G migrants reported mostly the desire to understand their roots. The values, the concern for the community and the longing to develop relationships are the motivations for which all young migrants continue to volunteer; however, 1G migrants are also sustained by advocacy and ethno-cultural motivations. Implications and future directions are discussed.

scholarly journals The performance and genetic variation of first and second generation tropical alfalfa (Medicago sativa)

2021 ◽  
Vol 22 (6) ◽  
Author(s):  
Bambang Suwignyo ◽  
LUKMANA ARIFIN ◽  
NAFIATUL UMAMI ◽  
MUHLISIN MUHLISIN ◽  
BAMBANG SUHARTANTO
Keyword(s):  
Organic Matter ◽  
Genetic Variation ◽  
Medicago Sativa ◽  
Crude Protein ◽  
Dry Matter ◽  
First Generation ◽  
Second Generation ◽  
Seed Viability ◽  
Nutrient Content ◽  
First And Second Generation

Abstract. Suwignyo B, Arifin L, Umami N, Muhlisin, Suhartanto B. 2021. The performance and genetic variation of first and second generation tropical alfalfa (Medicago sativa). Biodiversitas 22: 3265-3270. This study aimed to compare the growth performance, nutrient content, seed viability, and genetic variation of first- and second-generation alfalfa (Medicago sativa L.). First and second-generation alfalfa seeds were obtained from the Forage and Pasture Science Laboratory, Department of Animal Nutrition and Feed Science, Faculty of Animal Science, Universitas Gadjah Mada (UGM), Yogyakarta, Indonesia. First generation alfalfa (F1) seeds were obtained from cross breeding of two different parental alfalfa varieties, namely, Canadian and local. The second-generation (F2) seeds were obtained from plants of the first-generation alfalfa (F1). A randomized design experiment was conducted using the two types of alfalfa (first- and second generation). Alfalfa from Canada as female parent was used as the baseline in the genetic masker test. Seeds were planted in a polybag, watered twice a day, and received 12 hours of daylight and 4 hours of artificial light. Plants were then harvested 8 weeks after planting by cutting the plant canopy. Genetic variation was examined using the Inter Simple Sequence Repeat (ISSR) method followed by descriptive analysis. Germination, plant height, dry matter content, organic matter, and crude protein were assessed as variables using a Student’s T-test. Our results showed that germination, plant height, leaf color, and nutrient content (dry matter, organic matter, and crude protein) of the first- and second-generation alfalfa plants were not significantly different. However, the second-generation alfalfa demonstrated better seed viability than the first generation plants, then it can be categorized as a new genotype (tropical alfalfa) based on genetic variation analysis.

Antipsychotic utilisation and persistence in Australia: A nationwide 5-year study

2021 ◽  
pp. 000486742110516
Author(s):  
Mark Taylor ◽  
Dante Dangelo-Kemp ◽  
Dennis Liu ◽  
Steve Kisely ◽  
Simon Graham ◽  
...  
Keyword(s):  
First Generation ◽  
Second Generation ◽  
Treatment Persistence ◽  
Persistence Time ◽  
Hazard Ratios ◽  
Second Generation Antipsychotics ◽  
Time In Treatment ◽  
Second Generation Antipsychotic ◽  
Long Acting ◽  
Subsequent Relapse

Objectives: To evaluate the utilisation and persistence of antipsychotics for the treatment of schizophrenia in Australia. Methods: A retrospective study using the Australian Pharmaceutical Benefits Scheme database of a representative 10% sample. All adults with schizophrenia who were dispensed three or more supplies of oral (including clozapine) or long-acting injectable antipsychotics between 1 June 2015 and 31 May 2020 were included. Persistence time in treatment was evaluated using survival analysis and Cox hazard ratios. Results: In all, 26,847 adults with schizophrenia were studied. Oral second-generation antipsychotics were more frequently dispensed than the other antipsychotic groups studied. Median treatment persistence times were 18.3 months for second-generation antipsychotic long-acting injectables, 10.7 months for oral second-generation antipsychotics and were significantly lower for both formulations of first-generation antipsychotics at 5.2 months (long-acting injectables) and 3.7 months (oral). The median persistence time for clozapine was significantly longer than all other antipsychotics groups. Conclusions: Oral second-generation antipsychotics and second-generation antipsychotic long-acting injectables accounted for over 75% and 13% of all antipsychotics in Australia, respectively. Concerns over medication adherence and subsequent relapse have not translated into increased long-acting injectable usage despite their significantly longer persistence. Clozapine, the single most ‘persistent’ antipsychotic, was only used in 9% of people, although up to a third of all cases are likely to be treatment-resistant. Our data suggest clinicians should give consideration to the earlier use of second-generation antipsychotic long-acting injectables and clozapine, to ameliorate prognosis in schizophrenia.

Differential Impairments in Incentive Learning Caused by First‐ and Second‐ Generation Antipsychotic Drugs

2016 ◽  
Author(s):  
Matthew Florczynski
Keyword(s):  
Neural Control ◽  
First Generation ◽  
Antipsychotic Drugs ◽  
Second Generation ◽  
Operant Chamber ◽  
Incentive Learning ◽  
Dopamine Receptor Antagonists ◽  
Natural Response ◽  
Second Generation Antipsychotic ◽  
First And Second Generation

Schizophrenia is a neuropsychiatric disorder characterized by increased function of dopamine in the brain.  Dopamine release is a natural response to reward.  It promotes incentive learning (IL), a process by which neutral stimuli acquire the ability to elicit approach and other responses.  A recent model characterizes dopamine‐mediated IL as a progressive process with early and late stages accompanied by a shift in neural control from the nucleus accumbens (NAc) to the dorsolateral striatum (DLS).  A parallel can be drawn to differences in regionally specific neural responses generated by first‐ and second‐generation antipsychotic drugs (APDs) used to treat schizophrenia.  APDs are dopamine receptor antagonists, but first‐generation APDs affect the NAc and DLS while second‐generation APDs affect primarily the NAc.  We compared the effects of APDs on IL. Rats (N = 48) were trained to press a lever forfood pellets in an operant chamber.  Intraperitoneal injections (1 hr before testing) of the first‐generation APD haloperidol (0,0.05,0.10,0.20 mg/kg) or of the second‐generation APD risperidone (0,0.20,0.40,0.80 mg/kg) induced dose‐dependent suppression of lever pressing on days 1‐4, with the highest dose groups failing to demonstrate any evidence of previous learning on day 5 when tested drug‐free.  On days 16‐20 haloperidol induced a day‐to‐day suppression not seen with risperidone.  The results suggest that the effects of first‐ and second‐generation APDs on learning processes putatively mediated by the NAc and DLS can be differentiated experimentally.  The findings imply that APDs may differentially affect IL inpatients with schizophrenia.  

4.  Differential Impairments in Incentive Learning Caused by First‐ and Second‐ Generation Antipsychotic Drugs

2016 ◽  
Author(s):  
Matthew Florczynski
Keyword(s):  
Neural Control ◽  
First Generation ◽  
Antipsychotic Drugs ◽  
Second Generation ◽  
Operant Chamber ◽  
Incentive Learning ◽  
Dopamine Receptor Antagonists ◽  
Natural Response ◽  
Second Generation Antipsychotic ◽  
First And Second Generation

Schizophrenia is a neuropsychiatric disorder characterized by increased function of dopamine in the brain.  Dopamine release is a natural response to reward.  It promotes incentive learning (IL), a process by which neutral stimuli acquire the ability to elicit approach and other responses.  A recent model characterizes dopamine‐mediated IL as a progressive process with early and late stages accompanied by a shift in neural control from the nucleus accumbens (NAc) to the dorsolateral striatum (DLS).  A parallel can be drawn to differences in regionally specific neural responses generated by first‐ and second‐generation antipsychotic drugs (APDs) used to treat schizophrenia.  APDs are dopamine receptor antagonists, but first‐generation APDs affect the NAc and DLS while second‐generation APDs affect primarily the NAc.  We compared the effects of APDs on IL. Rats (N = 48) were trained to press a lever for food pellets in an operant chamber.  Intraperitoneal injections (1 hr before testing) of the first‐generation APD haloperidol (0,0.05,0.10,0.20 mg/kg) or of the second‐generation APD risperidone (0,0.20,0.40,0.80 mg/kg) induced dose‐dependent suppression of lever pressing on days 1‐4, with the highest dose groups failing to demonstrate any evidence of previous learning on day 5 when tested drug‐free.  On days 16‐20, haloperidol induced a day‐to‐day suppression not seen with risperidone.  The results suggest that the effects of first‐ and second‐generation APDs on learning processes putatively mediated by the NAc and DLS can be differentiated experimentally.  The findings imply that APDs may differentially affect IL inpatients with schizophrenia.

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