Efficacy of atypical<i>v.</i>typical antipsychotics in the treatment of early psychosis: meta-analysis

Crossley, Nicolás; Constante, Miguel; McGuire, Philip; Power, Paddy

doi:10.1192/bjp.bp.109.066217

Cited by 134 publications

(99 citation statements)

References 51 publications

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“…63 Atypical antipsychotic medications are well known to result in weight gain when used clinically in humans. 64 Exposure of C. elegans to either clozapine or olanzipine results in fat accumulation that is apparent after only 48 h. 63 Olanzapine produces a dose-dependent increase in Nile Red accumulation in fat tissue, which reaches statistical significance at dosage of 100 mM and above. 63 Quetiapine induces fat accumulation also, but less than that with olanzapine or clozapine.…”

Section: Elegans In Obesity Research J Zheng and Fl Greenwaymentioning

confidence: 99%

Caenorhabditis elegans as a model for obesity research

Zheng

Greenway

2011

Int J Obes

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Caenorhabditis elegans (C. elegans) is a small nematode that conserves 65% of the genes associated with human disease, has a 21-day lifespan, reproductive cycles of 3 days, large brood sizes, lives in an agar dish and does not require committee approvals for experimentation. Research using C. elegans is encouraged and a Caenorhabditis Genetics Center (CGC, Minnesota) is funded by the National Institutes of Health-National Center for Research Resources. Many genetically manipulated strains of C. elegans are available at nominal cost from the CGC. Studies using the C. elegans model have explored insulin signaling, response to dietary glucose, the influence of serotonin on obesity, satiety, feeding and hypoxia-associated illnesses. C. elegans has also been used as a model to evaluate potential obesity therapeutics, explore the mechanisms behind single gene mutations related to obesity and to define the mechanistic details of fat metabolism. Obesity now affects a third of the US population and is becoming a progressively more expensive public health problem. Faster and less expensive methods to reach more effective treatments are clearly needed. We present this review hoping to stimulate interest in using the C. elegans model as a vehicle to advance the understanding and future treatment of obesity.

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Section: Elegans In Obesity Research J Zheng and Fl Greenwaymentioning

confidence: 99%

Caenorhabditis elegans as a model for obesity research

Zheng

Greenway

2011

Int J Obes

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“…Apesar de alguns estudos sugerirem perí-odos maiores, de até 5 anos de manutenção do tratamento, a extensão do tratamento deverá ser vista caso a caso, a depender da gravidade dos sintomas iniciais, aderência ao tratamento, tempo e qualidade de resposta ao tratamento, e recuperação funcional dos doentes 34,45 . As diretrizes do National Institute for Health and Clinical Excellence (NICE), do Reino Unido, retiraram a recomendação do uso de antipsicóticos atípicos como tratamento de escolha de primeira linha, corroborando achados inconclusivos de algumas metanálises sobre a superioridade (tamanho de efeito) dos antipsicóticos atípicos sobre os típicos no PEP 46,47 . 48,49 .…”

Section: Medicaçõesunclassified

First-Episode Psychosis: Emergency Assistance

Gouvêa¹,

Noto²,

Bonadia³

et al. 2014

RDP

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16 revista debates em psiquiatria -Nov/Dez 2014 zar, é usado para descrever um estado mental em que o indivíduo perde o contato com a realidade, manifestando caracteristicamente delírios, alucinações, pensamento e/ou comportamento desorganizado. A etapa inicial de manifestação dos sintomas psicóticos, em que a intensidade dos mesmos leva uma quebra evidente do funcionamento, define o primeiro episódio psicótico (PEP FIRST-EPISODE PSYCHOSIS: EMERGENCY ASSISTANCEResumo O termo psicose é usado para descrever um estado mental em que o indivíduo perde o contato com a realidade, e a etapa inicial de manifestação dos sintomas psicóticos define o primeiro episódio psicótico (PEP). Este artigo apresenta conceitos e dados gerais sobre PEP, apresenta fatores de risco e provê orientações sobre o diagnóstico (inclusive diagnósticos diferenciais), tratamento e acompanhamento de pacientes com PEP, com destaque para o papel das emergências psiquiátricas. As diferentes fases das psicoses também são descritas. Como conclusão, os autores salientam a importância da identificação e investigação dos casos, o início precoce do tratamento e o acompanhamento aproximado e individualizado dos pacientes.Palavras-chave: Psicoses, primeiro episódio psicótico, emergência psiquiátrica. AbstractThe term psychosis is used to describe a mental state in which the individual loses contact with reality, and the first step in the manifestation of psychotic symptoms is referred to as first-episode psychosis. This article presents general concepts and data on first-episode psychosis, describes risk factors, and provides guidance on the diagnosis (including differential diagnosis), treatment, and follow-up of these patients, with special attention to the role played by psychiatric emergency centers. The different phases of psychoses are also described. The authors conclude by underscoring the importance of identifying and investigating cases of first-episode psychosis, beginning treatment as early as possible, and maintaining a close, individualized follow-up regimen.

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“…SGAs have demonstrated higher weight gain propensities compared with FGAs in early psychosis, amounting to 2.1 kg on average [Crossley et al 2010]. Five of the seven included studies on which the estimate was based lasted 1-2 years.…”

Section: Schizophreniamentioning

confidence: 99%

“…In one of the included studies, first-episode patients had more EPS than multiepisode patients. Crossley and colleagues performed a meta-analysis in early psychosis and found a significant advantage for SGAs over FGAs regarding Parkinsonism [Crossley et al 2010]. One particular form of EPS, the tardive or late dyskinesias (TD), has been investigated in a 2004 systematic review of studies with at least 1-year of follow up [Correll et al 2004], and with a 2008 update [Correll and Schenk, 2008].…”

Section: Schizophreniamentioning

confidence: 99%

Drug treatment developments in schizophrenia and bipolar mania: latest evidence and clinical usefulness

Johnsen

Kroken

2012

Therapeutic Advances in Chronic Disease

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Schizophrenia and bipolar disorder are often highly debilitating with chronic courses, and psychotropic drugs represent cornerstones in the treatment. The primary aim of the review was to summarize the latest evidence with regards to the efficacy and effectiveness of drug treatment of schizophrenia and the manic phases of bipolar disorder. Schizophrenia systematic reviews conclude that antipsychotic drugs are effective in treating overall symptoms of psychosis and in preventing relapse. Some of the newer agents, the secondgeneration antipsychotics (SGAs), have demonstrated superiority compared with the older first-generation drugs and other SGAs but side-effect differences among the drugs are of a greater magnitude than effect differences. The pragmatic randomized trials of effectiveness have shown a longer time until treatment discontinuation for olanzapine compared with other antipsychotics. Cohort studies have found superiority for the long-acting injection formulations compared with the oral formulations of the drugs, and lower total mortality risk in users of antipsychotics compared with non-users. In bipolar mania SGAs have shown superior antimanic efficacy compared with other mood-stabilizing drugs. In conclusion antipsychotics, in particular some of the SGAs, seem to be drugs of first choice for both schizophrenia and bipolar mania. This perspective review focused on mean effects but the group means may not always be particularly useful as schizophrenia and bipolar mania are biologically heterogeneous disorders with large inter-individual variations in drug response and tolerance. In patients with a prior drug history the different pharmacological and clinical profiles may be exploited in subsequent choices of drugs.

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Efficacy of atypicalv.typical antipsychotics in the treatment of early psychosis: meta-analysis

Abstract: There was no evidence for differences in efficacy between atypical and typical antipsychotics, but there was a clear difference in the side-effect profile.

Cited by 134 publications

References 51 publications

Caenorhabditis elegans as a model for obesity research

Caenorhabditis elegans as a model for obesity research

First-Episode Psychosis: Emergency Assistance

Drug treatment developments in schizophrenia and bipolar mania: latest evidence and clinical usefulness

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