Diurnal neurobiological alterations after exposure to clozapine in first-episode schizophrenia patients

Sun, Hongqiang; Li, Suxia; Chen, Fang-Bin; Zhang, Yan; Li, Peng; Jin, Mei; Sun, Yan; Wang, Fan; Mi, Weifeng; Shi, Le; Yue, Jing-Li; Yang, Fude; Lü, Lin

doi:10.1016/j.psyneuen.2015.11.013

Cited by 40 publications

(29 citation statements)

References 51 publications

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“…Using our search methods, 1248 articles were found. Applying our inclusion and exclusion criteria reduced the number of relevant articles to fifteen , ten of which evaluated CLZ as a first‐line treatment , while five were clinical reports that evaluated CLZ as a second‐line treatment (Fig. ) .…”

Section: Resultsmentioning

confidence: 99%

“…There were two case reports and eight trials investigating CLZ as a first‐line treatment. Detailed information about the outcomes mentioned in these papers can be found in the Supplementary Results.…”

Section: Resultsmentioning

confidence: 99%

“…Both case reports concluded CLZ was effective (there was no active comparator). Four trials (50%) provided summary statistics in line with CLZ being equally effective to other antipsychotics , while four trials (50%) pointed to increased efficacy of CLZ over other antipsychotics .…”

Section: Resultsmentioning

confidence: 99%

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Clozapine as a first‐ or second‐line treatment in schizophrenia: a systematic review and meta‐analysis

Okhuijsen-Pfeifer

Huijsman

Hasan

et al. 2018

Acta Psychiatr Scand

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ObjectiveNo consensus exists on whether clozapine should be prescribed in early stages of psychosis. This systematic review and meta‐analysis therefore focus on the use of clozapine as first‐line or second‐line treatment in non‐treatment‐resistant patients.MethodsArticles were eligible if they investigated clozapine compared to another antipsychotic as a first‐ or second‐line treatment in non‐treatment‐resistant schizophrenia spectrum disorders (SCZ) patients and provided data on treatment response. We performed random‐effects meta‐analyses.ResultsFifteen articles were eligible for the systematic review (N = 314 subjects on clozapine and N = 800 on other antipsychotics). Our meta‐analysis comparing clozapine to a miscellaneous group of antipsychotics revealed a significant benefit of clozapine (Hedges’ g = 0.220, P = 0.026, 95% CI = 0.026–0.414), with no evidence of heterogeneity. In addition, a sensitivity analysis revealed a significant benefit of clozapine over risperidone (Hedges’ g = 0.274, P = 0.030, 95% CI = 0.027–0.521).ConclusionThe few eligible trials on this topic suggest that clozapine may be more effective than other antipsychotics when used as first‐ or second‐line treatment. Only large clinical trials may comprehensively probe disease stage‐dependent superiority of clozapine and investigate overall tolerability.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Clozapine as a first‐ or second‐line treatment in schizophrenia: a systematic review and meta‐analysis

Okhuijsen-Pfeifer

Huijsman

Hasan

et al. 2018

Acta Psychiatr Scand

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“…In this perspective, psychiatric disorders might reflect a loss of synchronization between the external environment’s rhythms and the individual’s internal rhythms, leading to major problems of adaptation for the individual and the appearance of psychiatric disorders. Single-nucleotide polymorphisms (SNPs) in core circadian clock genes have been associated with autism spectrum disorder [89], attention deficit hyperactivity disorder [90,91], anxiety disorder [92], major depressive disorder [93,94,95], bipolar disorder [95,96,97] and schizophrenia [98,99,100,101]. However, the causal relationship for these associations remains to be better ascertained.…”

Section: Relationships Between Circadian Rhythms and Psychiatric Dmentioning

confidence: 99%

“…The T3111C polymorphism of the Clock gene might be associated with aberrant dopaminergic transmission in the suprachiasmatic nucleus, which is presumably involved in the pathophysiology of schizophrenia [157]. More recently, two studies focused on white blood cells and fibroblast from smaller samples: Sun et al [100] reported altered expressions of Per1 , Per2 , Per3 and Npas2 in white blood cells in individuals with schizophrenia. Indeed, compared with healthy controls, schizophrenia patients presented disruptions in diurnal rhythms of the expression of Per1 , Per3 , and Npas2 , accompanied by a delayed phase in the expression of Per2 and by a decreasing in Per3 and Npas2 expression.…”

Section: Relationships Between Circadian Rhythms and Psychiatric Dmentioning

confidence: 99%

Clock Genes and Altered Sleep–Wake Rhythms: Their Role in the Development of Psychiatric Disorders

Charrier

Olliac

Roubertoux

et al. 2017

IJMS

143

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In mammals, the circadian clocks network (central and peripheral oscillators) controls circadian rhythms and orchestrates the expression of a range of downstream genes, allowing the organism to anticipate and adapt to environmental changes. Beyond their role in circadian rhythms, several studies have highlighted that circadian clock genes may have a more widespread physiological effect on cognition, mood, and reward-related behaviors. Furthermore, single nucleotide polymorphisms in core circadian clock genes have been associated with psychiatric disorders (such as autism spectrum disorder, schizophrenia, anxiety disorders, major depressive disorder, bipolar disorder, and attention deficit hyperactivity disorder). However, the underlying mechanisms of these associations remain to be ascertained and the cause–effect relationships are not clearly established. The objective of this article is to clarify the role of clock genes and altered sleep–wake rhythms in the development of psychiatric disorders (sleep problems are often observed at early onset of psychiatric disorders). First, the molecular mechanisms of circadian rhythms are described. Then, the relationships between disrupted circadian rhythms, including sleep–wake rhythms, and psychiatric disorders are discussed. Further research may open interesting perspectives with promising avenues for early detection and therapeutic intervention in psychiatric disorders.

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Impaired Glucose Homeostasis in First-Episode Schizophrenia

et al. 2017

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Diurnal neurobiological alterations after exposure to clozapine in first-episode schizophrenia patients

Cited by 40 publications

References 51 publications

Clozapine as a first‐ or second‐line treatment in schizophrenia: a systematic review and meta‐analysis

Clozapine as a first‐ or second‐line treatment in schizophrenia: a systematic review and meta‐analysis

Clock Genes and Altered Sleep–Wake Rhythms: Their Role in the Development of Psychiatric Disorders

Impaired Glucose Homeostasis in First-Episode Schizophrenia

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