Olanzapine in the long-term treatment of schizophrenia

1999 ◽  
Vol 174 (S37) ◽  
pp. 26-29 ◽  
Author(s):  
John Kane

The primary aim of the long-term treatment of patients with schizophrenia is to prevent relapse, which is costly both in psychological and economic terms. Although with conventional antipsychotic drugs relapse may occur despite compliance with maintenance regimens, the rate of relapse is reduced in compliant patients. However, this benefit is achieved at the cost of side-effects and the risk of developing tardive dyskinesia, even among patients who have taken these drugs for only a year or two. To provide the therapeutic benefits of maintenance medication without its drawbacks, intermittent dosing and long-term therapy with reduced doses of conventional medications have been explored. The atypical antipsychotic agent, olanzapine, has been shown to be effective maintenance medication and has an improved safety profile.

1975 ◽  
Vol 3 (2) ◽  
pp. 114-124 ◽  
Author(s):  
Lucian Floru

The literature on neuroleptics with substance-specific long-term effects (fluspirilene, penfluridol) is reviewed in tabular form. This is followed by a report of personal investigations on 76 schizophrenics who were treated with fluspirilene initially within the hospital and later on an out-patient basis, on 86 patients who were treated with it exclusively at the out-patients' department, as well as on 123 schizophrenic psychoses treated with penfluridol in the out-patients' department. The side-effects caused by the two substances are compared. Pre-requisites for effective long-term therapy with a few complications are discussed.


2006 ◽  
Vol 12 (3) ◽  
pp. 363-366 ◽  
Author(s):  
Norman Putzki ◽  
Sabine Knipp ◽  
T im Ramczykowski ◽  
Susanne Vago ◽  
Ulrich Germing ◽  
...  

Azathioprine (Aza) is a widely used immunosuppressive drug in multiple sclerosis (MS) treatment. Recently, the incidence of secondary myelodysplastic syndromes (sMDS) associated with a poor prognosis was found to be elevated in patients treated with Aza for non-malign disorders. Three hundred and seventeen MS patients were retrospectively analysed and complete blood counts were examined for those exposed to Aza. We identified one case of sMDS (cumulative dose 627 g) in a young patient and two further malignancies (cumulative doses 27 g and 54 g) in the Aza group ( n=81; 3.7%). In the non-Aza ( n=236) group, five malignancies (2.1%, P=0.419) were identified. Including our patient, four cases of sMDS after long-term Aza therapy in MS have been reported so far. Cases suggest a time- and dose-dependent risk of sMDS in long-term therapy of MS with Aza. Long-term Aza therapy needs careful monitoring.


1992 ◽  
Vol 6 (2_suppl) ◽  
pp. 330-333 ◽  
Author(s):  
Iain Glen

There is no increase in the overall mortality of patients undergoing long-term lithium treatment compared with those receiving short-term treatment. Lithium causes a reduction in the incidence of suicide in patients suffering from manic depressive illness. Long-term treatment with lithium is more effective than treatment with imipramine or amitriptyline. Drug interactions may cause problems during long-term therapy with lithium. A reduction in plasma levels of lithium should be considered in stable patients on long-term prophylaxis. Discontinuation of therapy often results in a relapse. The toxicity of lithium is related to its effects on calcium transport.


Author(s):  
Weiwei Zeng ◽  
Brian Tomlinson

We conducted a prospective open-label cohort study with the aim of examining the effects of the highly β1-selective agent bisoprolol on central aortic systolic pressure (CASP) after the first dose and after 6 weeks’ treatment and whether the CASP response could be predicted from the early response. Chinese patients with primary hypertension (BP ≥ 140/90 mmHg) on no therapy or background amlodipine were treated with bisoprolol 2.5 mg daily for 6 weeks. Brachial systolic BP (Br-SBP), resting heart rate (HR) and CASP were determined at baseline, 24h after the first dose, and pre-dose after treatment for 6 weeks using the BPro® device. In 42 patients (age 54 ± 9 years) the mean reductions in CASP and Br-SBP after 6 weeks of treatment were not significantly different from each other at -14.5 ± 12.7 and -15.4 ± 12.9 mmHg (both p<0.01), respectively. Changes in CASP and Br-SBP were highly correlated after the first dose (r = 0.964, p<0.01) and after 6 weeks (r = 0.963, p<0.01) and the reductions in CASP after 6 weeks were also associated with the reduction in CASP after the first dose (r = 0.577, p<0.01). Bisoprolol was shown to effectively reduce CASP and this effect was directly proportional to the reduction in Br-SBP and of a similar magnitude. More favourable CASP responses to long term therapy may be predicted by greater reductions in CASP after the first dose.


1995 ◽  
Vol 9 (2_suppl) ◽  
pp. 191-198 ◽  
Author(s):  
Roger Lane

The long-term outlook for patients with unipolar depression is often poor. As few as one-fifth will remain well and a similar number will suffer chronic depression. It is now standard practice to extend acute treatment into a 4–6 month period of continuation therapy, and the value of prophylactic treatment over longer periods is becoming more widely recognised. Care must, however, be exercised in choosing suitable long-term treatment. Relatively little work on the prophylactic efficacy of the tricyclic antidepressants has been carried out, although imipramine has been shown to be effective. The selective serotonin re-uptake inhibitors (SSRIs) have been studied extensively and may be the most suitable long-term treatment for depression. Sertraline is effective in preventing both relapse and recurrence of depression and was the first agent specifically indicated for the long-term treatment of depression in the UK. In addition to clinical efficacy, many other factors favour SSRIs in the long-term management of depression. The tolerability of a drug is of major importance in long-term therapy since it affects compliance. Other important considerations include toxicity, safety in overdose, drug interaction potential, psychomotor effects and accident liability.


CNS Spectrums ◽  
2003 ◽  
Vol 8 (S2) ◽  
pp. 26-28 ◽  
Author(s):  
Daniel E. Casey

ABSTRACTThe long-term management of schizophrenia with a goal of functional rehabilitation remains an enormous challenge to clinicians despite improvements in drug therapy, psychosocial treatments, and family and community interventions. The goals of long-term therapy are to preserve the gains made during acute treatment, prevent symptom exacerbation, enhance psychosocial functioning, and improve quality of life. Schizophrenia is an illness that disrupts broad areas of mental function, including thought, cognition, affect, and motor performance. The new antipsychotics should aid physicians in meeting higher treatment goals for persons with schizophrenia. These agents combine high efficacy with improved tolerability, mainly through a low liability for extrapyramidal symptoms and probably improve cognitive affect. Recent studies have demonstrated efficacy of these new antipsychotics in improving psychopathology and symptoms and in preventing relapse during long-term use. These drugs are likely to provide physicians with an increasingly viable option in the long-term treatment and rehabilitation of patients with schizophrenia.


2018 ◽  
Vol 10 (1) ◽  
pp. e2018043 ◽  
Author(s):  
Matteo Chinello ◽  
Daniela Di Carlo ◽  
Francesca Olivieri ◽  
Rita Balter ◽  
Massimiliano De Bortoli ◽  
...  

Background: Kaposiform Hemangioendothelioma (KHE) is a rare vascular tumour of the infancy and of the first decade of life. It is locally aggressive and potentially life threatening when associated to consumptive coagulopathy, known as Kasabach-Merritt syndrome (KMS). No consensus or guideline for the therapy has been reached because of the lack of prospective trials and the different standard care suggestions are based on retrospective case series.Case report: We report the case of a 9-month-old male with KHE and KMS in which the initial response, obtained with prednisone and vincristine, was subsequently consolidated and strengthened by long-term treatment with sirolimus, an mTOR inhibitor. A summary of the published data is presented as well.Conclusions: The inhibition of mTOR pathway represents the most important therapeutic innovation introduced in the last few years for KHE. Our case shows the effectiveness and good tolerance of long-term therapy with sirolimus.Keywords: Kaposiform Hemangioendothelioma, Kasabach-Merrit syndrome, sirolimus, prednisone, vincristine


2018 ◽  
Author(s):  
Annelyn Torres-Reverón ◽  
Leslie L. Rivera-Lopez ◽  
Idhaliz Flores ◽  
Caroline B. Appleyard

AbstractEndometriosis is a disorder in which endometrial tissue is found outside the uterus causing pain, infertility and stress. Finding an effective and long-term treatment for endometriosis still remains one of the most significant challenges in the field. Corticotropin releasing hormone (CRH) is one of the main signaling peptides within the hypothalamic pituitary adrenal (HPA) axis released in response to stress. CRH can affect nervous and visceral tissues such as the uterus and gut via activation of two types of CRH receptors: CRHR1 and CRHR2. Our aim was to determine if blocking CRHR1 with antalarmin will reduce endometriosis progression. First, we induced endometriosis in female rats by suturing uterine horn tissue next to the intestinal mesentery and allowed to progress for 7 days. We determined that after 7 days, there was a significant increase in CRHR1 within endometriotic vesicles as compared to normal uterus. A second group of rats received endometriosis but also antalarmin (20 mg/kg, i.p.) during the first 7 days after surgery. As separate group of sham surgery rats served as controls. Endometriosis was allowed to progress until 60 days after surgery. At time of sacrifice, rats were tested for anxiety behaviors and endometriotic vesicles, and uterus were collected. Rats with endometriosis that received antalarmin significantly reduced the size (67% decrease) and number (30% decrease) of endometriotic vesicles. Antalarmin also prevented the increase in CRH and CRHR1 within endometriotic vesicles but not of glucocorticoid receptor. Behaviorally, endometriosis increased anxiety in the zero-maze test but antalarmin did not modify it. Our data provides the first demonstration for the effective use on CRHR1 antagonist for the treatment of endometriosis with promising effects for long-term therapy of this debilitating disease.


1992 ◽  
Vol 127 (5) ◽  
pp. 392-396 ◽  
Author(s):  
Jürgen R Bierich ◽  
Klaus Nolte ◽  
Konrad Drews ◽  
Gerd Brügmann

During recent years numerous reports on the favourable results of short-term trials with GH in patients with constitutional delay of growth and adolescence (CDGA) have been published, but it has been unclear whether such treatment affects final height. In the present study, the results of long-term therapy with GH in replacement doses have been evaluated in 15 patients who were treated with GH for several years (three years on average). At the start of treatment, 10 of the children were prepubertal and 5 were in puberty. All patients were followed up until final height was reached. Mean final height of the 13 male patients was 170.0±4.4 cm, i.e. −1.58 sds. In the two female patients, final height was 150.0 cm (−3.5 sds) and 164.0cm (−0.8 sds), respectively. Adult height of the patients lagged behind target height by 5.4±3.2 cm (mean±sd), Measured adult height corresponded to adult height as predicted prior to treatment. In conclusion, GH treatment of patients with CDGA did not increase final height.


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