scholarly journals The use of antipsychotics in targeted therapy of schizophrenia — prospects and challenges (for example, amisulpride).

2021 ◽  
pp. 83-89
Author(s):  
Olena Khaustova ◽  
Dmytro Assonov
Keyword(s):  
Personalized Medicine ◽  
Atypical Antipsychotics ◽  
Individual Characteristics ◽  
Psychological Characteristics ◽  
Response To Treatment ◽  
Psychotic Symptoms ◽  
Antipsychotic Therapy ◽  
Somatic Disorders ◽  
Personalized Psychiatry

Personalized medicine is an innovative approach that takes into account the biological, social and psychological characteristics of people in the development of preventive drugs and treatment of diseases. The goals of personalized medicine in psychiatry are to anticipate a person’s susceptibility to disease, achieve accurate diagnosis, and facilitate a favorable response to treatment. This article analyzes the information presented in the literature on use of antipsychotics in treatment of schizophrenia from the standpoint of personalized medicine with the aim to draw up recommendations for improving the effectiveness of psychotic symptoms therapy and set the vector for further scientific research in this direction. Despite the existence of many international and local guidelines and protocols for antipsychotic therapy, there is still the problem of early determination of which antipsychotic will be effective and safe for a particular patient — before the most effective drug is determined, patients are usually treated with various antipsychotics. In the treatment of schizophrenia, no antipsychotic drug or dosage is universal. Therefore, to maximize the useful effect and minimize the risk of side effects, numerous individual characteristics of each individual user must be considered. In particular, such characteristics as sex, age, clinical features (dominant symptoms, time of onset of symptoms and their intensity), comorbid mental and somatic disorders, presence/absence of bad habits, response to previous therapy (in case of such) should be taken into account. Given the possibility of flexible dosage of amisulpride and its significant effectiveness in reducing various groups of symptoms in various categories of patients, it has the potential for widespread use in personalized psychiatry. Key words personalized medicine, atypical antipsychotics, effectiveness of therapy

scholarly journals Evaluation of Efficacy, Safety, and Cognitive Profile of Amisulpride Per Se and Its Comparison with Olanzapine in Newly Diagnosed Schizophrenic Patients in an 8-Week, Double-Blind, Single-Centre, Prospective Clinical Trial

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Ganesh R. Pawar ◽  
P. Phadnis ◽  
A. Paliwal
Keyword(s):  
Clinical Trial ◽  
Adverse Effects ◽  
Negative Symptoms ◽  
Atypical Antipsychotics ◽  
Rating Scale ◽  
Cognitive Profile ◽  
Response To Treatment ◽  
Psychotic Symptoms ◽  
Double Blind ◽  
Minimal Impact

Background. Impaired cognitive functions in schizophrenia are the major deciding factors in response to treatment. Conventional antipsychotics have minimal impact on cognitive dysfunctions and are associated with adverse effects. Atypical antipsychotics have shown promise in treatment of cognitive and negative symptoms of schizophrenia. Efforts are underway to find out the best drug amongst atypical antipsychotics. Objective. To compare efficacy, safety, and cognitive profile of amisulpride and olanzapine in the treatment of acute psychotic exacerbations of schizophrenia. Method. A prospective, randomized, double-blind, single-center, 8-week clinical trial we used. Subjects and Treatments. Seventy four patients were treated for two months with either amisulpride (400–800 mg/d) or olanzapine (10–20 mg/d). Statistics. Mann Whitney U test we used for independent samples with taken as significant. Results. Brief psychiatric rating scale (BPRS) was used as a primary measure of efficacy. Other measures of efficacy and safety were also evaluated. Both amisulpride and olanzapine groups showed equivalent improvement in psychotic symptoms on BPRS scale. Less than five percent of patients suffered adverse effects only to withdraw from the study. Olanzapine group showed statistically significant () weight gain compared with amisulpride group. Amisulpride group showed significant improvement () in various cognitive parameters as compared to olanzapine group.

Neuropsychiatric Symptoms and Antipsychotic Therapy in the Elderly Patients with Dementia

Psychiatry ◽  
2020 ◽  
Vol 18 (4) ◽  
pp. 6-15
Author(s):  
I. V. Kolykhalov
Keyword(s):  
Neuropsychiatric Symptoms ◽  
The Elderly ◽  
Psychotic Symptoms ◽  
Mixed Dementia ◽  
Short Term ◽  
Antipsychotic Therapy ◽  
Dementia Patients ◽  
Frequency Of Use ◽  
Number Of Patients ◽  
High Incidence

The objective of the study was to investigate syndromal-nosological specificities of neuropsychiatric symptoms (NPS) and the frequency of use of antipsychotics in patients with various types of dementias, institutionalized to geriatric units of mental hospitals.Patients and methods: a total of 106 in-patients of three psychogeriatric units were examined. The median age of patients is 75 years [69; 80].The diagnostic distribution of patients at the time of the examination was as follows: in 33 subjects (31.1%) Alzheimer’s disease (AD) was diagnosed, in 25 (23.6%) - mixed dementia (MD), in 32 (30.2%) - vascular dementia (VD) and in 16 (15.1%) patients had dementia of complex origin (DCO).Results: a high incidence (54.7%) of NPS was found in patients with dementia of various origins. The greatest number of patients with behavioral and psychotic symptoms was found in AD and MD. The proportion of dementia patients with such disorders in each of these types of dementia is about 70%, while in CGD and VD, the proportion of patients with NPS is noticeably smaller (30% and 40%, respectively). For the treatment of NPS, antipsychotics were most often prescribed, but their use caused adverse events (AEs) in 1/3 of cases. Patients with VD are most susceptible to the development of AE, and AD patients are the least susceptible.Conclusion: the study showed that NPS are one of the important components of dementia, regardless of the nosology and stage of the disease. The treatment of NPS in dementia is particularly challenging because, although the symptoms cause significant distress, there are currently no effective alternative therapies. The risk of AE can be minimized by carefully considering the indications for prescribing antipsychotics and their short-term use, regular monitoring of the patient’s condition, and educating caregivers.

Methamphetamine use and psychotic symptoms: findings from a New Zealand longitudinal birth cohort

2021 ◽  
pp. 1-8
Author(s):  
Joseph M. Boden ◽  
James A. Foulds ◽  
Giles Newton-Howes ◽  
Rebecca McKetin
Keyword(s):  
New Zealand ◽  
General Population ◽  
Birth Cohort ◽  
Individual Characteristics ◽  
Psychotic Symptoms ◽  
Confounding Factors ◽  
Long Term Effects ◽  
Methamphetamine Use ◽  
Increased Risk ◽  
Psychosis Risk

Abstract Background This study examined the association between methamphetamine use and psychotic symptoms in a New Zealand general population birth cohort (n = 1265 at birth). Methods At age 18, 21, 25, 30, and 35, participants reported on their methamphetamine use and psychotic symptoms in the period since the previous interview. Generalized estimating equations modelled the association between methamphetamine use and psychotic symptoms (percentage reporting any symptom, and number of symptoms per participant). Confounding factors included childhood individual characteristics, family socioeconomic circumstances and family functioning. Long term effects of methamphetamine use on psychotic symptoms were assessed by comparing the incidence of psychotic symptoms at age 30–35 for those with and without a history of methamphetamine use prior to age 30. Results After adjusting for confounding factors and time-varying covariate factors including concurrent cannabis use, methamphetamine use was associated with a modest increase in psychosis risk over five waves of data (adjusted odds ratio (OR) 1.33, 95% confidence interval (CI) 1.03–1.72 for the percentage measure; and IRR 1.24, 95% CI 1.02–1.50 for the symptom count measure). The increased risk of psychotic symptoms was concentrated among participants who had used at least weekly at any point (adjusted OR 2.85, 95% CI 1.21–6.69). Use of methamphetamine less than weekly was not associated with increased psychosis risk. We found no evidence for a persistent vulnerability to psychosis in the absence of continuing methamphetamine use. Conclusion Methamphetamine use is associated with increased risk of psychotic symptoms in the general population. Increased risk is chiefly confined to people who ever used regularly (at least weekly), and recently.

scholarly journals Implementing Personalized Medicine in COVID-19 in Andalusia: An Opportunity to Transform the Healthcare System

2021 ◽  
Vol 11 (6) ◽  
pp. 475
Author(s):  
Joaquín Dopazo ◽  
Douglas Maya-Miles ◽  
Federico García ◽  
Nicola Lorusso ◽  
Miguel Ángel Calleja ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Clinical Practice ◽  
Personalized Medicine ◽  
Local Level ◽  
Individual Variability ◽  
Response To Therapy ◽  
Control Measures ◽  
Response To Treatment ◽  
Specific Patient

The COVID-19 pandemic represents an unprecedented opportunity to exploit the advantages of personalized medicine for the prevention, diagnosis, treatment, surveillance and management of a new challenge in public health. COVID-19 infection is highly variable, ranging from asymptomatic infections to severe, life-threatening manifestations. Personalized medicine can play a key role in elucidating individual susceptibility to the infection as well as inter-individual variability in clinical course, prognosis and response to treatment. Integrating personalized medicine into clinical practice can also transform health care by enabling the design of preventive and therapeutic strategies tailored to individual profiles, improving the detection of outbreaks or defining transmission patterns at an increasingly local level. SARS-CoV2 genome sequencing, together with the assessment of specific patient genetic variants, will support clinical decision-makers and ultimately better ways to fight this disease. Additionally, it would facilitate a better stratification and selection of patients for clinical trials, thus increasing the likelihood of obtaining positive results. Lastly, defining a national strategy to implement in clinical practice all available tools of personalized medicine in COVID-19 could be challenging but linked to a positive transformation of the health care system. In this review, we provide an update of the achievements, promises, and challenges of personalized medicine in the fight against COVID-19 from susceptibility to natural history and response to therapy, as well as from surveillance to control measures and vaccination. We also discuss strategies to facilitate the adoption of this new paradigm for medical and public health measures during and after the pandemic in health care systems.

Psychological factors of student youth‘s responsible behavior.

2020 ◽  
Vol 89-90 (4-5) ◽  
pp. 93-101
Author(s):  
Tatyana Fadeeva ◽  
Keyword(s):  
Social Responsibility ◽  
Self Esteem ◽  
Psychological Characteristics ◽  
Educational Organizations ◽  
Social Desirability Scale ◽  
Self Confidence ◽  
Responsible Behavior ◽  
Symptom Complex ◽  
Similarities And Differences

The article considers the problem of studying the determinants of the types of responsible behavior of young people. It is assumed that there are similarities and differences in the determination of the types of responsible behavior of the youth. The study involved 70 students (average age – 22 years old, SD = 2.19; men – 12%). We used the standardized methods "Questionnaire for the diagnosis of the personal symptom complex of responsibility" (Kocharyan I.A.), "Methods for the study of self-attitude" (Panteleev S.R.), the questionnaire "Determining the level of self-esteem" (Kovalev S.V.), "Social Desirability Scale" (D. Crown, D. Marlowe). We established that the most pronounced types of social behavior of youth are "ethics" and "self-sacrifice". It is shown that the severity of the type of social responsibility is determined by various combinations of psychological characteristics. The most complex regression equation characterizes the type of responsible behavior “Normalizations”. The least pronounced prediction of responsible behavior was revealed in relation to its types: "Fidelity to principle" and "Self-confidence". The results of this study can be useful for further study of the problems of social responsibility, as well as for the development of programs for the formation of youth's social responsibility in educational organizations.

scholarly journals Association analysis between the C516T polymorphism in the 5-HT2A receptor gene and schizophrenia

2007 ◽  
Vol 65 (1) ◽  
pp. 11-14 ◽  
Author(s):  
Vivian Bertola ◽  
Quirino Cordeiro ◽  
Stevin Zung ◽  
Elisabete Cristina Miracca ◽  
Homero Vallada
Keyword(s):  
Atypical Antipsychotics ◽  
Receptor Gene ◽  
Epidemiological Studies ◽  
Case Control ◽  
Psychotic Symptoms ◽  
Serotonin 2A Receptor ◽  
Brazilian Sample ◽  
Control Approach ◽  
Serotonergic Drugs ◽  
Serotonin 2A

Data from epidemiological studies have demonstrated that genetics is an important risk factor for schizophrenia. Disturbances of serotonergic brain pathways have been implicated in the pathophysiology of schizophrenia. Some studies have suggested that the efficacy of atypical antipsychotics on schizophrenia treatment may be related to the serotonin 2A receptor (5-HT2A), and that serotonergic drugs may induce psychotic symptoms. Thus, the aim of this study was to investigate the association between the C516T polymorphism and schizophrenia in a Brazilian population composed by 246 patients and 315 healthy matched controls in a case-control approach. No statistically differences were observed in allelic (chi2=1.77, 1d.f., p=0.18) or genotypic (chi2=1.69, 2d.f., p=0.42) distributions between cases and controls. The results suggest that the C516T polymorphism of the 5-HT2A receptor gene is not related to the susceptibility for schizophrenia in our Brazilian sample.

Biomarkers for mitochondrial energy metabolism diseases

2018 ◽  
Vol 62 (3) ◽  
pp. 443-454 ◽  
Author(s):  
Sara Boenzi ◽  
Daria Diodato
Keyword(s):  
Diagnostic Algorithm ◽  
Mitochondrial Respiratory Chain ◽  
Response To Treatment ◽  
Fibroblast Growth Factor 21 ◽  
Disease Group ◽  
Diagnostic Challenge ◽  
Mitochondrial Energy Metabolism ◽  
Lactate And Pyruvate ◽  
Urine Organic Acids

Biomarkers are an indicator of biologic or pathogenic processes, whose function is indicating the presence/absence of disease or monitoring disease course and its response to treatment. Since mitochondrial disorders (MDs) can represent a diagnostic challenge for clinicians, due to their clinical and genetic heterogeneity, the identification of easily measurable biomarkers becomes a high priority. Given the complexity of MD, in particular the primary mitochondrial respiratory chain (MRC) diseases due to oxidative phosphorylation (OXPHOS) dysfunction, a reliable single biomarker, relevant for the whole disease group, could be extremely difficult to find, most of times leading the physicians to better consider a ‘biosignature’ for the diagnosis, rather than a single biochemical marker. Serum biomarkers like lactate and pyruvate are largely determined in the diagnostic algorithm of MD, but they are not specific to this group of disorders. The concomitant determination of creatine (Cr), plasma amino acids, and urine organic acids might be helpful to reinforce the biosignature in some cases. In recent studies, serum fibroblast growth factor 21 (sFGF21) and serum growth differentiation factor 15 (sGDF15) appear to be promising molecules in identifying MD. Moreover, new different approaches have been developed to discover new MD biomarkers. This work discusses the most important biomarkers currently used in the diagnosis of MRC diseases, and some approaches under evaluation, discussing both their utility and weaknesses.

scholarly journals Some individual psychological characteristics as protective or risk factors for occurrence of conduct disorder

Psihologija ◽  
2011 ◽  
Vol 44 (2) ◽  
pp. 167-185
Author(s):  
Jasminka Markovic ◽  
Jelena Srdanovic-Maras ◽  
Valentina Sobot ◽  
Svetlana Ivanovic-Kovacevic ◽  
Sladjana Martinovic-Mitrovic
Keyword(s):  
Conduct Disorder ◽  
Behavioral Problems ◽  
Protective Factor ◽  
Conduct Disorders ◽  
Individual Characteristics ◽  
Psychological Characteristics ◽  
Stress Coping ◽  
Coping With Stress ◽  
Healthy Siblings ◽  
Stress Coping Strategies

Our study included 30 pairs of siblings aged 12-18 years; one sibling with and one without conduct disorder in each pair. The aim of the study was to assess individual characteristics of those siblings, i.e. to determine differences in psychological characteristics of the siblings with regard to locus of control, stress coping strategies and frequency and structure of behavioral problems and emotions. The results suggested significant differences in individual characteristics of children with conduct disorder and their healthy siblings. These results mainly confirm previous results of foreign research on a sample of our population. Exception of findings was related to strategies for coping with stress: religious behavior that didn?t turn out as a protective factor and avoiding confrontation and withdrawal which are shown as a protective factor. These results suggest the importance of individual psychological characteristics for the occurrence of conduct disorders and have implications in therapy and in preventive work with adolescents.

scholarly journals Prescribing patterns for psychotic and behavioural symptoms in dementia: a national survey

2002 ◽  
Vol 26 (8) ◽  
pp. 288-290 ◽  
Author(s):  
K. Scott ◽  
R. M. Lawrence ◽  
A. Duggal ◽  
C. Darwin ◽  
E. Brooks ◽  
...  
Keyword(s):  
Atypical Antipsychotics ◽  
Prescribing Patterns ◽  
Psychotic Symptoms ◽  
Clinical Implications ◽  
Behavioural Symptoms ◽  
Anonymous Questionnaire ◽  
Prescribing Practice ◽  
Drug Treatments ◽  
Old Age Psychiatry ◽  
Sexual Disinhibition

Aims and MethodTo compare current prescribing practice for psychotic and behavioural symptoms in dementia with the available research. An anonymous questionnaire was sent to all members of the Faculty of Old Age Psychiatry, enquiring about preferred drug treatments.ResultsClassical antipsychotics were chosen by 50% for psychotic symptoms over atypical antipsychotics (43%) and were preferred for aggression (48%) and sexual disinhibition (55%). Antidepressants were favoured in treating anxiety (41%) and lability (45%).Clinical ImplicationsAlternatives to classical antipsychotics, especially for behavioural symptoms, have yet to be researched satisfactorily. In view of the continued widespread use of classical antipsychotics and recent concerns about their safety, we call for this to be addressed.

scholarly journals Pharmacoeconomic analysis of using typical and atypical antipsychotics in schizophrenia

2018 ◽  
Vol 11 (2) ◽  
pp. 9-24
Author(s):  
I. A. Vilyum ◽  
B. V. Andreev ◽  
M. A. Proskurin ◽  
Yu. E. Balykina
Keyword(s):  
Cost Effectiveness ◽  
Atypical Antipsychotics ◽  
Impact Analysis ◽  
Pharmacoeconomic Analysis ◽  
Cost Effectiveness Analysis ◽  
Resource Saving ◽  
Antipsychotic Therapy ◽  
Healthcare Budget ◽  
Effectiveness Analysis ◽  
The Cost

The aim: to provide a comprehensive pharmacoeconomic evaluation of the maintenance therapy with antipsychotics in outpatients diagnosed with schizophrenia.Materials and methods. The analysis was conducted by two mutually complementary steps: an epidemiological study on outpatients with schizophrenia, and a subsequent pharmacoeconomic modeling. Two medical technologies were evaluated and compared: treatment with classical antipsychotics (kA) and treatment with atypical antipsychotics (AA). For the clinical and economic analysis of these treatments, we used a number of indices derived from our retrospective study of patients’ medical records. The cost-effectiveness analysis, incremental analysis, and «budget impact» analysis were performed taking into account the direct and indirect costs of the treatments.Results. We determined the costs of managing outpatients with schizophrenia from the perspective of the healthcare budget and the social burdens; we also looked into the relevance and effectiveness of the current costs at various time intervals – 6, 12 and 24 months. As shown, the treatment strategies involving AA were more budget-consumptive than the kA treatments. even if the treatments were switched to the reproduced AA (up to 100% replacement), the costs would remain to be higher than those for the kA. The «cost-effectiveness» analysis related to «the proportion of stable patients» for the horizons of 6 and 12 months indicated that the reproduced AA would be more economically effective than the kA. However, when the observation period was increased to 24 months, this economic advantage of AA diminished, and the kA drugs had a lower CeR instead. For the «number of hospitalization-free days per year», the use of AA was more cost-effective only versus the 100% use of reproduced AA at the simulated horizon of 12 months. When the use of 100% reference AA or the combined use of reference + reproduced AA was simulated, the treatment with kA remained more economically effective, regardless of the simulated period.Conclusion. The pharmacoeconomic simulation of the antipsychotic therapy in outpatients with schizophrenia suggests the ways to optimize the treatment. Among them, (a) using AA for the treatment of at least 15.6% of patients (those who are employed); keeping the ≥60% use of kA to ensure the optimal resource-saving effect of the treatment; (b) using reproduced AA at the level of ≥70% (instead of the reference AA similar in efficacy and safety) to keep the treatment economically feasible. 

Sign in / Sign up

Export Citation Format

Share Document