Atypical Antipsychotics: Part II Adverse Effects, Drug Interactions, and Costs

Brown, Candace; Markowitz, John S.; Moore, Thea R.; Parker, Nicole G

doi:10.1345/aph.17216

Cited by 100 publications

(74 citation statements)

References 40 publications

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“…probability of anti-Parkinsonian agent usage anti-Parkinsonian medication increased with increasing risperidone dose) indicated that risperidone was likely to be the reason for antiParkinsonian medication usage/EPS incidence. This is consistent with the reported dose-related EPS side effects of risperidone (Brown et al, 1999;Love and Nelson, 2000).…”

Section: Discussionsupporting

confidence: 91%

Drug utilization review of risperidone for outpatients in a tertiary referral hospital in Singapore

Luo

Koh

Tan

et al. 2004

Human Psychopharmacology

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The mean risperidone dose during the study period was towards the lower end of recommendation for schizophrenia. Further study is warranted to confirm and explain the pattern of low-dose risperidone, and the high use of concomitant conventional antipsychotics and anti-Parkinsonian agents in Singapore. Elucidation of these would provide a valuable insight for the management of Asian patients with schizophrenia using risperidone. However, the current data indicate that the practice of using a lower dose of risperidone could represent better affordability and an improved cost-effectiveness ratio of risperidone compared with conventional antipsychotics in Asian patients.

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Section: Discussionsupporting

confidence: 91%

Drug utilization review of risperidone for outpatients in a tertiary referral hospital in Singapore

Luo

Koh

Tan

et al. 2004

Human Psychopharmacology

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“…Pretreatment with olanzapine completely eliminated cocaine self-administration in three of four subjects, and markedly suppressed responding to less than 10% of control rates in the fourth subject. Effective doses of olanzapine were within the therapeutic dose range for treatment of psychosis in humans (Brown et al, 1999;Albers et al, 2005). In separate experiments, substitution of olanzapine for cocaine failed to maintain self-administration behavior above saline extinction levels in any subject.…”

Section: Discussionmentioning

confidence: 82%

Olanzapine-Induced Suppression of Cocaine Self-Administration in Rhesus Monkeys

Howell

Wilcox

Lindsey

et al. 2005

Neuropsychopharmacol

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The neuropharmacological profile of the atypical antipsychotic, olanzapine, is consistent with a potentially useful medication for cocaine abuse. The present study utilized an i.v. drug self-administration paradigm in nonhuman primates to obtain definitive evidence regarding the effectiveness of olanzapine to modulate the reinforcing effects of cocaine. The effects of olanzapine were compared directly to those of the neuroleptic, haloperidol. Rhesus monkeys (n ¼ 7) were trained to self-administer cocaine (0.03-0.3 mg/kg/injection) under a second-order, fixed-interval 600-s schedule with fixed ratio 20 components. Experimental sessions comprised five consecutive fixed intervals, each followed by a 1-min timeout. In drug-interaction experiments, a single dose of olanzapine (0.03-0.3 mg/kg) or haloperidol (0.01-0.03 mg/kg) was administered i.v. 15 min presession for at least three consecutive sessions. In drug-substitution experiments, different doses of olanzapine (0.01-0.1 mg/kg/injection) were substituted for cocaine until responding stabilized. Olanzapine caused doserelated decreases in cocaine self-administration at pretreatment doses that had no overt behavioral effects indicative of sedation. A dose of 0.1 mg/kg eliminated cocaine self-administration in all subjects. In contrast, doses of haloperidol that suppressed cocaine selfadministration induced marked sedation and catalepsy. Olanzapine failed to maintain self-administration behavior above saline extinction levels over a range of unit doses. In vivo microdialysis experiments in a second group of awake rhesus monkeys (n ¼ 3) confirmed previous reports in rodents that olanzapine effectively increases extracellular dopamine in ventral striatum. The dose of olanzapine that markedly suppressed cocaine self-administration behavior increased dopamine to approximately 190% of control values. Lastly, pretreatment with fluoxetine had no systematic effect on olanzapine-induced increases in striatal dopamine. The results indicate that olanzapine can effectively suppress cocaine self-administration behavior in nonhuman primates at doses that enhance dopamine release but do not maintain drug self-administration.

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“…However, TAs are associated with diminished tolerability and patient compliance due in part to a high incidence of adverse extrapyramidal side effects including parkinsonism and tardive dyskinesia (Brown, Markowitz, Moore, & Parker, 1999;Dolder et al, 2002). TAs are reported to have only partial efficacy against negative, cognitive, and depressive symptoms of schizophrenia and are associated with patients' complaints of reduced quality of life (Csernansky & Schuchart, 2002;Naber et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

The Relationship of Antipsychotic Medication Class and Adherence with Treatment Outcomes and Costs for Florida Medicaid Beneficiaries with Schizophrenia

Becker

Young

Ochshorn

et al. 2007

Adm Policy Ment Health

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While some studies show a significant advantage in adherence rates with use of atypical versus typical antipsychotic medication, others show no advantage or mixed results (Jones et al. (2006). Archives of General Psychiatry, 63, 1079-1087; Rosenheck, (2006). Archives of General Psychiatry, 63, 1074-1076). This study examined treatment outcomes and costs associated with adherence rates by antipsychotic medication class for adult Medicaid beneficiaries in Florida diagnosed with schizophrenia. Outcomes examined include arrests, involuntary commitments, and physical and behavioral healthcare costs. Study findings demonstrate that medication adherence for persons with schizophrenia may be as important to treatment costs and benefits as the class of medication used.

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Atypical Antipsychotics: Part II Adverse Effects, Drug Interactions, and Costs

Cited by 100 publications

References 40 publications

Drug utilization review of risperidone for outpatients in a tertiary referral hospital in Singapore

Drug utilization review of risperidone for outpatients in a tertiary referral hospital in Singapore

Olanzapine-Induced Suppression of Cocaine Self-Administration in Rhesus Monkeys

The Relationship of Antipsychotic Medication Class and Adherence with Treatment Outcomes and Costs for Florida Medicaid Beneficiaries with Schizophrenia

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