Book Review: Clinical handbook of psychotropic drugs, 19th revised edition

Virani, Adil; Bezchlibnyk-Butler, Kalyna; Jeffries, J. Joel; Procyshyn, Ric M.; Puzantian, Talia

doi:10.9740/mhc.n104535

Cited by 11 publications

(18 citation statements)

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“…Typical antipsychotics are dopaminergic antagonists which act on the three main ways of neurotransmitters, while atypical antipsychotics have, generally, affinity for both dopaminergic and serotoninergic receptors, being more selective for limbic system [10]. Aripiprazole differs from other atypical antipsychotics, being partial agonist of dopaminergic receptors and is thus considered by some authors like a third generation antipsychotic [11].…”

Section: Romanian Journal Of Diabetes Nutrition and Metabolic Diseases mentioning

confidence: 99%

Assessment of Long Term Metabolic Effects of Atypical Antipsychotics in Schizophrenia Patients

Cason¹,

Babeş

Béres

et al. 2019

Romanian Journal of Diabetes Nutrition and Metabolic Diseases

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Background and aims. Patients with schizophrenia have a shorter life expectancy than normal population partially due to the metabolic side effects of antipsychotic treatment. The aim of this study is to evaluate the long-term evolution of the metabolic syndrome in chronic schizophrenia patients on fixed second generation antipsychotics (SGA). Material and method. The components of metabolic syndrome were evaluated repeatedly in a minimum 6 months and maximum 2 years follow-up period. The presence of metabolic syndrome (MetS) and metabolic risk scores (cMetS) according to National Cholesterol Education Program Adult Treatment Panel III were calculated and compared in time. In the prevalence, incidence and normalization logistic regression studies included all the known risk factors together with the follow-up period. Finally, all these rates were compared depending on the type of SGA. Results. Only cMetS, waist circumference and diastolic blood pressure presented significant increase in the follow-up period which was in average 385.5 days. The prevalence of MetS at base-line was 39.4%, which increased to 48.5% after the follow-up period. The calculated incidence of 30% was associated with a 23.1% rate of normalization. Logistic regression studies revealed as independent risk factors the age and base-line cMetS/weight for incidence and for normalization. In the aripiprazole group the normalization rate exceeded the incidence rate (33.3% vs 20%). Conclusions. The results emphasize the highly dynamic character of the metabolic syndrome even in chronic schizophrenia patients with fixed SGA regimen. The normalization of MetS is a possibility that should not ignored. The age and weight continue to remain independent risk factors, thus close monitoring in elderly and strict weight control plan are necessary. Aripiprazole showed better safety profile, but more extensive studies are required for definitive conclusions.

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Section: Romanian Journal Of Diabetes Nutrition and Metabolic Diseases mentioning

confidence: 99%

Assessment of Long Term Metabolic Effects of Atypical Antipsychotics in Schizophrenia Patients

Cason¹,

Babeş

Béres

et al. 2019

Romanian Journal of Diabetes Nutrition and Metabolic Diseases

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“…It has poor oral bioavailability, because it is inactivated by gastric acid and undergoes significant first-pass metabolism in the liver. It is metabolized by cytochrome P450 (CYP) 3A4 to various metabolites, including the active norbuprenorphine 28,32. Peak plasma concentrations are achieved in 90–150 minutes following administration, and the μ-receptor blockade can last for 3–5 days due to the slow dissociation from the receptor, allowing for the possibility of alternate-day dosing 39…”

Section: Pharmacology/pharmacokineticsmentioning

confidence: 99%

“…Naloxone binds tightly to the opioid receptor without producing a euphoric effect, thereby blocking or reversing the psychoactive effects of partial- or full-opioid agonists 40. Naloxone has poor bioavailability in the sublingual form; therefore, it does not alter buprenorphine’s properties when the medication is taken as prescribed 28,41. If bup/nx is injected, however, sufficient naloxone is absorbed to precipitate acute withdrawal in opiate-dependent users, thus discouraging further abuse via the intravenous route of administration 40,42,43…”

Section: Pharmacology/pharmacokineticsmentioning

confidence: 99%

“…The initial dose is 2–4 mg buprenorphine, which is increased based on clinical symptoms up to a total first-day dose of 8 mg 28. The goal is to reach the target dose of 12–16 mg buprenorphine during the first week 34.…”

Section: Strategy For Clinical Managementmentioning

confidence: 99%

“…It has a lower risk of respiratory depression than full agonists, and is associated with less QTc prolongation than methadone 98,99. Liver-function tests should be periodically monitored 28,100…”

Section: Patient-focused Perspectivesmentioning

confidence: 99%

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Utilizing buprenorphine–naloxone to treat illicit and prescription-opioid dependence

Mauger¹,

Fraser²,

Gill³

2014

NDT

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ObjectivesTo review current evidence on buprenorphine–naloxone (bup/nx) for the treatment of opioid-use disorders, with a focus on strategies for clinical management and office-based patient care.Quality of evidenceMedline and the Cochrane Database of Systematic Reviews were searched. Consensus reports, guidelines published, and other authoritative sources were also included in this review. Apart from expert guidelines, data included in this review constitute level 1 evidence.FindingsBup/nx is a partial μ-opioid agonist combined with the opioid antagonist naloxone in a 4:1 ratio. It has a lower abuse potential, carries less stigma, and allows for more flexibility than methadone. Bup/nx is indicated for both inpatient and ambulatory medically assisted withdrawal (acute detoxification) and long-term substitution treatment (maintenance) of patients who have a mild-to-moderate physical dependence. A stepwise long-term substitution treatment with regular monitoring and follow-up assessment is usually preferred, as it has better outcomes in reducing illicit opioid use, minimizing concomitant risks such as human immunodeficiency virus and hepatitis C transmission, retaining patients in treatment and improving global functioning.ConclusionBup/nx is safe and effective for opioid detoxification and substitution treatment. Its unique pharmaceutical properties make it particularly suitable for office-based maintenance treatment of opioid-use disorder.

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48 echo T2 myelin imaging of white matter in first-episode schizophrenia: Evidence for aberrant myelination

Lang

Yip

MacKay

et al. 2014

NeuroImage: Clinical

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Myelin water imaging provides a novel strategy to assess myelin integrity and corresponding clinical relationships in psychosis, of particular relevance in frontal white matter regions. In the current study, T2 myelin water imaging was used to assess the myelin water fraction (MWF) signal from frontal areas in a sample of 58 individuals experiencing first-episode psychosis (FEP) and 44 healthy volunteers. No differences in frontal MWF were observed between FEP subjects and healthy volunteers; however, differences in normal patterns of associations between frontal MWF and age, education and IQ were seen. Significant positive relationships between frontal MWF and age, North American Adult Reading Test (NAART) IQ, and years of completed education were observed in healthy volunteers. In contrast, only the relationship between frontal MWF and NAART IQ was significant after Bonferroni correction in the FEP group. Additionally, significant positive relationships between age and MWF in the anterior and posterior internal capsules, the genu, and the splenium were observed in healthy volunteers. In FEP subjects, only the relationship between age and MWF in the splenium was statistically significant. Frontal MWF was not associated with local white matter volume. Altered patterns of association between age, years of education, and MWF in FEP suggest that subtle disturbances in myelination may be present early in the course of psychosis.

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Book Review: Clinical handbook of psychotropic drugs, 19th revised edition

Cited by 11 publications

References 0 publications

Assessment of Long Term Metabolic Effects of Atypical Antipsychotics in Schizophrenia Patients

Assessment of Long Term Metabolic Effects of Atypical Antipsychotics in Schizophrenia Patients

Utilizing buprenorphine–naloxone to treat illicit and prescription-opioid dependence

48 echo T2 myelin imaging of white matter in first-episode schizophrenia: Evidence for aberrant myelination

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Book Review: Clinical handbook of psychotropic drugs, 19th revised edition

Cited by 11 publications

References 0 publications

Assessment of Long Term Metabolic Effects of Atypical Antipsychotics in Schizophrenia Patients

Assessment of Long Term Metabolic Effects of Atypical Antipsychotics in Schizophrenia Patients

Utilizing buprenorphine&ndash;naloxone to treat illicit and prescription-opioid dependence

48 echo T2 myelin imaging of white matter in first-episode schizophrenia: Evidence for aberrant myelination

Contact Info

Product

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Utilizing buprenorphine–naloxone to treat illicit and prescription-opioid dependence