Efficacy and safety of lurasidone in children and adolescents: Recommendations for clinical management and future research

2021 ◽  
Vol 27 ◽  
Author(s):  
Andrea Amerio ◽  
Costanza Giacomini ◽  
Laura Fusar-Poli ◽  
Andrea Aguglia ◽  
Alessandra Costanza ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Clinical Management ◽  
Partial Agonist ◽  
Scientific Evidence ◽  
Antipsychotic Agent ◽  
Term Treatment ◽  
Good Choice ◽  
Future Research ◽  
Long Term Treatment ◽  
M1 Receptors

: Lurasidone is a novel azapirone derivative, and atypical antipsychotic agent with a high binding affinity for dopaminergic (D2), serotoninergic (5-HT2A), and 5-HT7 receptors (antagonist), a moderate affinity for 5-HT1A receptors (partial agonist), and no appreciable affinity for histaminergic (H1) and muscarinic (M1) receptors. It was recently included by the European Medication Agency among the in-label pharmacological treatments for children and adolescents affected by early onset schizophrenia. As a dopamine and serotonin antagonist, lurasidone acts on a variety of receptors and showed its efficacy both as an antipsychotic and an activating compound. Administered with food or within 30 minutes from a meal, it presents sufficient bioavailability and does not interact ith most of the other drugs during metabolism. With little effects on hormones and weight gain, potential procognitive profile due to its 5-HT7 antagonism, and reduced extrapyramidal side effects, lurasidone could be a good choice in terms of both effectiveness and tolerability, particularly for patients headed towards a long-term treatment. This article aims to summarize the available scientific evidence from the literature on the use of lurasidone in children and adolescents and to provide recommendations for clinical management and future research.

scholarly journals Lurasidone: a novel antipsychotic agent for the treatment of schizophrenia and bipolar depression

2015 ◽  
Vol 39 (5) ◽  
pp. 237-241 ◽  
Author(s):  
Antony Loebel ◽  
Leslie Citrome
Keyword(s):  
Bipolar Depression ◽  
Partial Agonist ◽  
Antipsychotic Agent ◽  
Term Treatment ◽  
Pharmacodynamic Profile ◽  
Long Term Treatment ◽  
The Usa ◽  
Major Depressive Episodes ◽  
Depressive Episodes ◽  
Novel Antipsychotic

SummaryLurasidone is a novel antipsychotic agent approved for the treatment of schizophrenia in a number of countries including the UK, and is also approved in the USA and Canada for the treatment of major depressive episodes associated with bipolar I disorder as either a monotherapy or adjunctive therapy with lithium or valproate. In addition to full antagonist activity at dopamine D2 (Ki(D2) = 1 nM) and serotonin 5-HT2A (Ki(5-HT2A) = 0.5 nM) receptors, the pharmacodynamic profile of lurasidone is notable for its high affinity for serotonin 5-HT7 receptors (Ki(5-HT7) = 0.5 nM) and its partial agonist activity at 5-HT1A receptors (Ki(5-HT1A) = 6.4 nM). Long-term treatment of schizophrenia with lurasidone has been shown to reduce the risk of relapse. Lurasidone appears associated with minimal effects on body weight and low risk for clinically meaningful alterations in glucose, lipids or electrocardiogram parameters.

scholarly journals Genetic Variations Associated with Long-Term Treatment Response in Bipolar Depression

Genes ◽  
2021 ◽  
Vol 12 (8) ◽  
pp. 1259
Author(s):  
Gerard Anmella ◽  
Silvia Vilches ◽  
Jordi Espadaler ◽  
Andrea Murru ◽  
Isabella Pacchiarotti ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Major Depression ◽  
Bipolar Depression ◽  
Scientific Evidence ◽  
Term Treatment ◽  
Response To Treatment ◽  
Clinical Predictors ◽  
Patient Response ◽  
Long Term Treatment ◽  
The Impact

Several pharmacogenetic-based decision support tools for psychoactive medication selection are available. However, the scientific evidence of the gene-drug pairs analyzed is mainly based on pharmacogenetic studies in patients with major depression or schizophrenia, and their clinical utility is mostly assessed in major depression. This study aimed at evaluating the impact of individual genes, with pharmacogenetic relevance in other psychiatric conditions, in the response to treatment in bipolar depression. Seventy-six patients diagnosed with bipolar disorder and an index major depressive episode were included in an observational retrospective study. Sociodemographic and clinical data were collected, and all patients were genotyped using a commercial multigene pharmacogenomic-based tool (Neuropharmagen®, AB-Biotics S.A., Barcelona, Spain). Multiple linear regression was used to identify pharmacogenetic and clinical predictors of efficacy and tolerability of medications. The pharmacogenetic variables response to serotonin-norepinephrine reuptake inhibitors (SNRIs) (ABCB1) and reduced metabolism of quetiapine (CYP3A4) predicted patient response to these medications, respectively. ABCB1 was also linked to the tolerability of SNRIs. An mTOR-related multigenic predictor was also associated with a lower number of adverse effects when including switch and autolytical ideation. Our results suggest that the predictors identified could be useful to guide the pharmacological treatment in bipolar disorder. Additional clinical studies are necessary to confirm these findings.

scholarly journals Pharmacogenomics and Efficacy of Risperidone Long-Term Treatment in Thai Autistic Children and Adolescents

2017 ◽  
Vol 121 (4) ◽  
pp. 316-324 ◽  
Author(s):  
Nopphadol Nuntamool ◽  
Nattawat Ngamsamut ◽  
Natchaya Vanwong ◽  
Apichaya Puangpetch ◽  
Monpat Chamnanphon ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Term Treatment ◽  
Autistic Children ◽  
Long Term Treatment

scholarly journals A consensus guideline for antipsychotic drug use for dementia in care homes. Bridging the gap between scientific evidence and clinical practice

2015 ◽  
Vol 27 (11) ◽  
pp. 1849-1859 ◽  
Author(s):  
Sytse U. Zuidema ◽  
Alice Johansson ◽  
Geir Selbaek ◽  
Matt Murray ◽  
Alistair Burns ◽  
...  
Keyword(s):  
Los Angeles ◽  
Practice Guideline ◽  
Treatment Plan ◽  
Scientific Evidence ◽  
Term Treatment ◽  
Care Homes ◽  
Delphi Consensus ◽  
People With Dementia ◽  
Long Term Treatment

ABSTRACTBackground:To produce a practice guideline that includes a set of detailed consensus principles regarding the prescription of antipsychotics (APs) amongst people with dementia living in care homes.Methods:We used a modified Delphi consensus procedure with three rounds, where we actively specified and optimized statements throughout the process, utilizing input from four focus groups, carried out in UK, Norway, and the Netherlands. This was done to identify relevant themes and a set of statement that experts agreed upon using the Research and Development/University of California at Los Angeles (RAND/UCLA) methodology.Results:A total of 72 scientific and clinical experts and 14 consumer experts reached consensus upon 150 statements covering five themes: (1) General prescription stipulations, (2) assessments prior to prescription, (3) care and treatment plan, (4) discontinuation, and (5) long-term treatment.Conclusions:In this practice guideline, novel information was provided about detailed indication and thresholds of symptoms, risk factors, circumstances at which APs should be stopped or tapered, specific criteria for justifying long-term treatment, involvement of the multidisciplinary team, and family caregiver in the process of prescription. The practice guideline is based on formal consensus of clinicians and consumer experts and provides clinicians relevant practical information that is lacking in current guidelines.

Treatment of conduct disorder: Progress and directions in psychotherapy research

1993 ◽  
Vol 5 (1-2) ◽  
pp. 277-310 ◽  
Author(s):  
Alan E. Kazdin
Keyword(s):  
Conduct Disorder ◽  
Developmental Psychopathology ◽  
Clinical Care ◽  
Psychotherapy Research ◽  
Term Treatment ◽  
Current Status ◽  
Future Research ◽  
Effective Interventions ◽  
Long Term Treatment ◽  
Treatment Research

AbstractThe present paper charts the course for future research on the treatment of conduct disorder. The course builds on current advances both in understanding conduct disorder and its treatment and in the clinical care provided to youth and their families. The paper highlights substantive and methodological advances in contemporary research on both treatment and developmental psychopathology more generally. In light of the current status of treatment research, several priorities are identified, which include expanding the criteria used to evaluate outcome, expanding the range of research questions asked about treatment, testing a broader range of treatments and treatment combinations, evaluating long-term treatment effects, and expanding the models to develop and to evaluate treatment. A plan is presented to guide the progression of research to identify and to develop effective interventions. The special opportunities that a developmental perspective provides for designing treatments for youth of different ages and stages of development are also discussed.

scholarly journals Independent and Interactive Effects of Neighborhood Disadvantage and Social Network Characteristics on Problem Drinking After Treatment

2018 ◽  
Vol 37 (1) ◽  
pp. 1-21 ◽  
Author(s):  
Amy A. Mericle ◽  
Lee A. Kaskutas ◽  
Doug L. Polcin ◽  
Katherine J. Karriker-Jaffe
Keyword(s):  
Social Network ◽  
Problem Drinking ◽  
Neighborhood Disadvantage ◽  
Term Treatment ◽  
Interactive Effects ◽  
Future Research ◽  
Network Characteristics ◽  
Disadvantaged Neighborhoods ◽  
Long Term Treatment ◽  
Reduced Drinking

Socioecological approaches to public health problems like addiction emphasize the importance of person-environment interactions. Neighborhood and social network characteristics may influence the likelihood of relapse among individuals in recovery, but these factors have been understudied, particularly with respect to conceptualizing social network characteristics as moderators of neighborhood disadvantage. Drawing from a larger prospective study of individuals recruited from outpatient treatment (N = 451) and interviewed 1, 3, 5, and 7 years later, the aim of this study was to examine the independent and interactive effects of neighborhood and social network characteristics on continued problem drinking after treatment. Models using generalized estimating equations controlling for demographic and other risk factors found the number of heavy drinkers in one's network increases risk of relapse, with the effects being significantly stronger among those living in disadvantaged neighborhoods than among those in non-disadvantaged neighborhoods. No independent effects were found for neighborhood disadvantage or for the number of network members supporting reduced drinking. Future research is needed to examine potential protective factors in neighborhoods which may offset socioeconomic disadvantage as well as to investigate the functions that network members serve in helping to improve long-term treatment outcomes.

scholarly journals Neuroinflammation in HIV-Related Neuropathic Pain

2021 ◽  
Vol 12 ◽  
Author(s):  
Huan-Jun Lu ◽  
Yuan-Yuan Fu ◽  
Qian-Qi Wei ◽  
Zhi-Jun Zhang
Keyword(s):  
Chronic Pain ◽  
Nervous System ◽  
Neuropathic Pain ◽  
Hiv Infection ◽  
Term Treatment ◽  
Future Research ◽  
Peripheral Sensitization ◽  
Long Term Treatment ◽  
Future Research Directions ◽  
Hiv Envelope

In the management of human immunodeficiency virus (HIV) infection around the world, chronic complications are becoming a new problem along with the prolonged life expectancy. Chronic pain is widespread in HIV infected patients and even affects those with a low viral load undergoing long-term treatment with antiviral drugs, negatively influencing the adherence to disease management and quality of life. A large proportion of chronic pain is neuropathic pain, which defined as chronic pain caused by nervous system lesions or diseases, presenting a series of nervous system symptoms including both positive and negative signs. Injury caused by HIV protein, central and peripheral sensitization, and side effects of antiretroviral therapy lead to neuroinflammation, which is regarded as a maladaptive mechanism originally serving to promote regeneration and healing, constituting the main mechanism of HIV-related neuropathic pain. Gp120, as HIV envelope protein, has been found to be the major toxin that induces neuropathic pain. Particularly, the microglia, releasing numerous pro-inflammatory substances (such as TNFα, IL-1β, and IL-6), not only sensitize the neurons but also are the center part of the crosstalk bridging the astrocytes and oligodendrocytes together forming the central sensitization during HIV infection, which is not discussed detailly in recent reviews. In the meantime, some NRTIs and PIs exacerbate the neuroinflammation response. In this review, we highlight the importance of clarifying the mechanism of HIV-related neuropathic pain, and discuss about the limitation of the related studies as future research directions.

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