Comparative Evaluation of Side Effects of Typical and Atypical Antipsychotics in Psychotic Patients at Punjab Institute of Mental Health, Lahore, Pakistan

Objective: To review the existing literature on the efficacy and tolerability of antipsychotics for adolescent psychosis. The review focuses in particular on literature regarding adverse effects that are thought to have an increased incidence in young patients and on the possible neurobiological bases for such differential sensitivity. Method: Pertinent studies were sought using Medline searches, supplemented by selected bibliographies, and reviewed. Results: There is a relative paucity of research in this area; in particular, well-controlled trials are lacking. The existing literature suggests fairly good efficacy of both typical and atypical antipsychotics in the treatment of psychotic disorders in children and adolescents. However, the incidence of certain side effects, particularly extrapyramidal symptoms (EPS), is found to be higher in young patients compared with adults. Positron emission tomography (PET) receptor studies in adults have demonstrated that the incidence of EPS is related to dose-dependent dopamine type-2 (D2) receptor occupancy and that there is a significant relationship between the number of these receptors and age. Conclusions: Improved tolerability is leading to the increasing use of atypical antipsychotics for adolescent patients, though these new drugs do have specific adverse effects of their own. There is a need for more controlled studies of atypical antipsychotics in children and adolescents. In particular, dose-finding studies are needed to determine the optimal dose range to produce the greatest improvement with the least side effects for each of these new drugs.

Download Full-text

Are all antipsychotic drugs the same?

The British Journal of Psychiatry ◽

10.1192/bjp.bp.111.095323 ◽

2011 ◽

Vol 199 (4) ◽

pp. 269-271 ◽

Cited By ~ 7

Author(s):

Stefan Leucht ◽

John M. Davis

Keyword(s):

Decision Making ◽

Side Effects ◽

Classification System ◽

Atypical Antipsychotics ◽

Antipsychotic Drugs ◽

Mechanisms Of Action ◽

Decision Making Process ◽

Shared Decision ◽

Typical And Atypical Antipsychotics ◽

Typical Antipsychotics

SummaryThe classification system of atypical and typical antipsychotics has created a lot of confusion and might be abandoned. Nevertheless, to say that all drugs are the same and that therefore it does not matter which drug is given is wrong. Both typical and atypical antipsychotics differ in side-effects, mechanisms of action, cost and efficacy. The available choice of antipsychotics should be adapted to individual patients in a shared decision-making process.

Download Full-text

Pharmacogenomics: A focus on antidepressants and atypical antipsychotics

Mental Health Clinician ◽

10.9740/mhc.2016.01.048 ◽

2016 ◽

Vol 6 (1) ◽

pp. 48-53 ◽

Cited By ~ 4

Author(s):

Jonathan F. Lister

Keyword(s):

Mental Health ◽

Side Effects ◽

Atypical Antipsychotics ◽

Psychiatric Care ◽

Clinical Effect ◽

Genomic Data ◽

Therapeutic Benefit ◽

Elevated Risk ◽

Response Side ◽

Medication Efficacy

Abstract The study of pharmacogenomics is rapidly growing, particularly in the field of mental health. Understanding pharmacogenomic principles can be a challenge for many clinicians. Most mental health genomic data concentrates on variability (response, side effects) with antidepressants and atypical antipsychotics. Current pharmacogenomic practice and research primarily focuses on two areas: pharmacodynamics and pharmacokinetics. Based on the current literature, genetic polymorphisms of pharmacodynamics and pharmacokinetics parameters likely influence medication efficacy, therefore affecting the therapeutic benefit. Additionally, certain pharmacodynamic and pharmacokinetic polymorphisms have been linked to an elevated risk of side effects and adverse events with these medications. In this review, specific pharmacodynamic and pharmacokinetic polymorphisms related to antidepressants and atypical antipsychotics will be discussed, as well as the potential clinical effect these genomic abnormalities have within psychiatric care.

Download Full-text

Use of atypical antipsychotics by consultant psychiatrists working in forensic settings

Psychiatric Bulletin ◽

10.1192/pb.26.5.172 ◽

2002 ◽

Vol 26 (5) ◽

pp. 172-174 ◽

Cited By ~ 4

Author(s):

Carol Paton ◽

Jose A. Garcia ◽

Deborah Brooke

Keyword(s):

Side Effects ◽

Serum Level ◽

Atypical Antipsychotics ◽

Response Rate ◽

Postal Questionnaire ◽

Clinical Implications ◽

Forensic Patients ◽

The Uk ◽

Level Monitoring ◽

Typical And Atypical Antipsychotics

AIMS AND METHODAtypical antipsychotics have less neurological side-effects than the older drugs but are only available as oral preparations. This may limit their use in forensic patients. We sent a postal questionnaire to all consultant psychiatrists working in forensic settings in the UK to determine their views.RESULTSThe response rate was 60%. Respondents tended to overestimate the benefits and underestimate the side-effects of the atypical antipsychotics. The majority often prescribed atypical antipsychotics and depots together. Psychoeducation and serum level monitoring were used to optimise/monitor compliance by 50%.CLINICAL IMPLICATIONSUsing atypical antipsychotics as monotherapy is problematic in forensic settings. The extent of polypharmacy means that patients may experience the side-effects of both typical and atypical antipsychotics. More could be done to facilitate and monitor compliance.

Download Full-text

Typical and Atypical Antipsychotics in Acute Mania: Comparison of Effectiveness

10.26226/morressier.5885d719d462b8028d891d95 ◽

2017 ◽

Author(s):

Clara Reece Medici

Keyword(s):

Atypical Antipsychotics ◽

Acute Mania ◽

Comparison Of Effectiveness ◽

Typical And Atypical Antipsychotics

Download Full-text

Beyond the high: Mapping patterns of use and motives for use of cannabis as medicine

Nordic Studies on Alcohol and Drugs ◽

10.1177/1455072520985967 ◽

2021 ◽

pp. 145507252098596

Author(s):

Sinikka L. Kvamme ◽

Michael M. Pedersen ◽

Sagi Alagem-Iversen ◽

Birgitte Thylstrup

Keyword(s):

Mental Health ◽

Side Effects ◽

Sleep Disturbances ◽

Online Survey ◽

Cannabis Use ◽

Health Conditions ◽

Convenience Sample ◽

Mental Health Conditions ◽

Patient Organisations ◽

Patterns Of Use

Background: In Denmark the boundaries between cannabis as an illicit drug and licit medicine have shifted rapidly in recent years, affecting also policy. However, the vast majority of Danes, who use cannabis as medicine (CaM) continue to rely on the unregulated market for supply. This study explores patterns of use and motives for use of CaM in Denmark. Methods: An anonymous online survey was made available to a convenience sample of users of CaM from July 14, 2018 to November 1, 2018. Participants were recruited through patient organisations, social and public media, and the illegal open cannabis market. Results: Of the final sample ( n = 3,021), a majority were women (62.6%) and the mean age was 49 years. Most had no prescription for CaM (90.9%), a majority had no or limited previous experience with recreational cannabis use (63.9%), and had used CaM for two years or less (65.0%). The most common form of intake was oil (56.8%) followed by smoke (24.0%). CBD oil (65.0%) was used more than hash, pot or skunk (36.2%). Most frequent conditions treated were chronic pain (32.0%), sleep disturbances (27.5%), stress (23.7%), osteoarthritis (22.7%), anxiety (19.6%), and depression (19.6%). Overall, users experienced CaM to be effective in managing somatic and mental health conditions and reported relatively few side-effects. CBD oil only users were more likely to be women, older, have limited recreational experience and have initiated use recently. Conclusions: A new user group has emerged in Denmark that, for the most part, use illegally sourced CaM to treat a broad range of somatic and mental health conditions, often with experienced effect and relatively low level of side-effects. The prevalent use of low-potency CBD oil indicates an interest in effects beyond the high normally associated with cannabis use. More clinical research into the effects and side-effects of CaM is needed to draw the boundaries of the medical utility of cannabis.

Download Full-text