Aripiprazole in Treatment-refractory Schizophrenia

Hsu, Wen-Yu; Lee, Chien-I; Chiu, Nan‐Ying; Kahn, David

doi:10.1097/01.pra.0000351883.75754.45

Cited by 5 publications

(1 citation statement)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, clozapine has been associated with side-effects and safety concerns of a potentially life-threatening nature and does not always elicit a complete response (2). According to treatment guidelines, augmentation of clozapine with a second antipsychotic is a reasonable strategy for the treatment of partially responsive patients (3,4), and it has been recognised that switching to or adding another antipsychotic and decreasing the dosage of clozapine may be of clinical benefit in patients with treatment-refractory schizophrenia (5). The augmentation strategy is an alternative approach in the treatment of patients suffering from either psychotic symptoms or side-effects; however, the benefits of the use of this strategy in treatment-resistant schizophrenia remain inconclusive (6).…”

mentioning

confidence: 99%

Augmentation of clozapine with paliperidone in treatment-resistant schizophrenia-A case series

Chang

Hsu

Huang

et al. 2011

Acta Neuropsychiatr.

View full text Add to dashboard Cite

mentioning

confidence: 99%

Augmentation of clozapine with paliperidone in treatment-resistant schizophrenia-A case series

Chang

Hsu

Huang

et al. 2011

Acta Neuropsychiatr.

View full text Add to dashboard Cite

Schizophrenia and Related Psychoses

2021

The Maudsley Prescribing Guidelines in Psychiatry

View full text Add to dashboard Cite

Despite disagreements about nomenclature, patients who develop schizophrenic or schizophrenialike symptoms in later life are often seen in clinical practice. Questions about the etiology of late-life psychotic disorders and about their similarities or differences from early-onset disorders remain unanswered. Neuroimaging techniques have been used to study patients with late onset of psychosis, and in substantial subgroups of patients (from 25% to 100% in various studies) compared with agematched control subjects, structural and functional abnormalities have been found. We review the literature on imaging in late-life schizophrenia and related psychotic disorders, and we present data from our own investigations of patients with these disorders. We discuss the potential usefulness of imaging evaluations in patients with late-onset disorders, and we offer suggestions for future investigations.

show abstract

Withdrawal Symptoms and Rebound Syndromes Associated with Switching and Discontinuing Atypical Antipsychotics: Theoretical Background and Practical Recommendations

et al. 2013

View full text Add to dashboard Cite

With the widespread use of atypical or second-generation antipsychotics, switching treatment has become current practice and more complicated, as the pharmacological profiles of these agents differ substantially despite their similarity in being 'atypical'. All share the ability to block dopamine D₂ receptors, and most of them also block serotonin 5-HT2A receptors. Apart from these common features, some atypical antipsychotics are also able to block or stimulate other dopamine or serotonin receptors, as well as histaminergic, muscarinergic or adrenergic receptors. As a result of the varying receptor affinities, in switching or discontinuing compounds several possible pitfalls have to be considered, including the occurrence of withdrawal and rebound syndromes. This article reviews the pharmacological background of functional blockade or stimulation of receptors of interest in regard to atypical antipsychotics and the implicated potential withdrawal and rebound phenomena. A MEDLINE search was carried out to identify information on withdrawal or rebound syndromes occurring after discontinuation of atypical antipsychotics. Using the resulting literature, we first discuss the theoretical background to the functional consequences of atypical antipsychotic-induced blockade or stimulation of neurotransmitter receptors and, secondly, we highlight the clinical consequences of this. We then review the available clinical literature on switching between atypical antipsychotics, with respect to the occurrence of withdrawal or rebound symptoms. Finally, we offer practical recommendations based on the reviewed findings. The systematic evaluation of withdrawal or rebound phenomena using randomized controlled trials is still understudied. Knowledge of pharmacological receptor-binding profiles may help clinicians in choosing adequate switching or discontinuation strategies for each agent. Results from large switching trials indicate that switching atypical antipsychotics can be performed in a safe manner. Treatment-emergent adverse events during or after switching are not always considered to be, at least in part, associated with the pre-switch antipsychotic. Further studies are needed to substantiate the evidence gained so far on different switching strategies. The use of concomitant medication, e.g., benzodiazepines or anticholinergic drugs, may help to minimize symptoms arising from the discontinuation or switching of antipsychotic treatment.

show abstract

Aripiprazole in Treatment-refractory Schizophrenia

Cited by 5 publications

References 25 publications

Augmentation of clozapine with paliperidone in treatment-resistant schizophrenia-A case series

Augmentation of clozapine with paliperidone in treatment-resistant schizophrenia-A case series

Schizophrenia and Related Psychoses

Withdrawal Symptoms and Rebound Syndromes Associated with Switching and Discontinuing Atypical Antipsychotics: Theoretical Background and Practical Recommendations

Contact Info

Product

Resources

About