Pharmacological treatment of schizophrenia - a review of progress

Dimitrelis, Konstantinos; Shankar, Rohit

doi:10.1002/pnp.430

Cited by 7 publications

(8 citation statements)

References 36 publications

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“…The ideal situation would be to have medication that addresses the symptoms of psychosis with minimal side effects. However, due to a lack of fundamental innovation in psychopharmacology during recent decades, we still have to work with antipsychotics with a range of motor, metabolic, and cognitive side effects (28, 44). Moreover, as there is still an overall favorable benefit-to-risk ratio for the use of antipsychotics (45), addressing lifestyle is of importance to help minimize such side effects.…”

Section: Discussionmentioning

confidence: 99%

Less Medication Use in Inpatients With Severe Mental Illness Receiving a Multidisciplinary Lifestyle Enhancing Treatment. The MULTI Study III

et al. 2018

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Besides having an unhealthy lifestyle contributing to premature mortality, inpatients with severe mental illness (SMI) use high dosages of medication. Previous research has shown improved health after lifestyle improvements in SMI. In addition, we aimed to retrospectively study whether a multidisciplinary lifestyle enhancing treatment (MULTI) was associated with changes in medication use after 18 months, as compared with patients that continued treatment as usual (TAU) and explored mediation by a change in physical activity. We conducted an observational study within a cohort of inpatients with SMI, who received MULTI (N = 65) or continued TAU (N = 49). Data on their somatic and psychotropic medications were collected, converted into defined daily dose (DDD), and analyzed using linear multilevel regression, correcting for baseline value and differences between groups in age, diagnosis, and illness severity. Compared with TAU, the DDD for psychotropic medication significantly decreased with MULTI (B = −0.55, P = 0.02). Changes in total activity did not mediate this association, suggesting that multiple components of MULTI contributed. Corrected between-group analyses for subgroups of medication were not possible due to lack of power and skewed distributions. Within-group data showed a decreased proportion of users as well as median DDD in both groups for almost all medications. In addition to previously reported health improvements after 18 months of MULTI, we observed a significant decrease in dose of psychotropic medication in MULTI compared to TAU. This first study evaluating a wide range of medications indicates a possible effect of lifestyle improvements on medication use in inpatients with SMI. Findings need to be confirmed in future controlled studies, however.

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Section: Discussionmentioning

confidence: 99%

Less Medication Use in Inpatients With Severe Mental Illness Receiving a Multidisciplinary Lifestyle Enhancing Treatment. The MULTI Study III

et al. 2018

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“…Because of its unique overall treatment concept and personalized drug composition for different patients, it is a good adjuvant therapy which shows substantial promise to improve clinical outcomes. Western medicine mainly treats chronic schizophrenia with atypical antipsychotic drugs such as aripiprazole, risperidone, olazine, and typical antipsychotic drugs like chlorpromazine and haloperidol, which are effective for first-episode schizophrenia, but not ideal for chronic schizophrenia ( Dimitrelis and Shankar, 2016 ). Numerous studies have suggested that the utilization of Chinese herbs in conjunction with western antipsychotics is beneficial in terms of mental state, holistic functioning, and decrease of adverse effects ( Rathbone et al, 2005 ).…”

Section: Discussionmentioning

confidence: 99%

Traditional Chinese Medicine Decoction Combined With Antipsychotic for Chronic Schizophrenia Treatment: A Systematic Review and Meta-analysis

et al. 2021

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Despite several studies suggesting the effectiveness of traditional Chinese medicine (TCM) in schizophrenia, there is still a lack of systematic summary and analysis on the role of TCM as adjuvant therapy in chronic schizophrenia. For this purpose, we conducted a meta-analysis to study the efficacy of TCM as an adjuvant combined with antipsychotics in the treatment of chronic schizophrenia. Until April 2020, based on the review of six electronic databases, eight articles were selected. The articles compared TCM decoction assisted antipsychotic therapies with an antipsychotic alone in the treatment of chronic schizophrenia by analyzing a total of 810 cases. The results showed that TCM combined with antipsychotics have beneficial effects on the Positive and Negative Syndrome Scale (PANSS), including the changes in total score, negative score, and the clinical effects evaluated by the PANSS scale. Subgroup analysis showed that the effects of auxiliary TCM with different efficacy on the positive and psychopathological scores were significantly different. It was found that adjuvant treatment with TCM can reduce some side effects and improve the patient's living conditions in the evaluation of the Schizophrenia Quality Of Life Scale (SQLS). Many studies have proved that TCM is safe and well-tolerated. Although the difficulties of using limited TCM remains to be generalized, it still has great potential in the adjuvant treatment of chronic schizophrenia.

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“…Lumateperone (4-((6b R ,10a S )-3-methyl-2,3,6b,9,10,10 a -hexahydro-1 H ,7 H -pyrido[3′,4′:4,5]pyrrolol[1,2,3- de ]-quinoxalin-8-yl)-1-(4-fluoro-phenyl)-butan-1-one 4-methylbenzenesulfonate), 43 also known as ITI-007 and ITI-722, exists as the tosylate salt 5,20,36,37,44 (Figure 1). The principal metabolite of lumateperone, ICI200131, is the alcohol produced by the reduction of the carbonyl side-chain by ketone reductase.…”

Section: Methodsmentioning

confidence: 99%

“…Those are common targets of other antipsychotic drugs that may cause adverse effects like weight gain, sedation, and orthostatic hypotension. 37 It displays a moderate binding affinity for dopamine D 4 and α-1 A and α-1 B adrenergic receptors (Ki protected at <100 nM), with a low binding affinity (<50% inhibition at 100 nM) for muscarinic and histaminergic receptors. 24…”

Section: Pharmacodynamicsmentioning

confidence: 99%

“…However, because lumateperone offers great promise to alleviate the suffering of people with schizophrenia, we seek to share our objective Introduction to the compound Lumateperone is an orally administered, atypical antipsychotic developed by Intra-Cellular Therapies (New York, NY, USA) for the treatment of schizophrenia and other neurologic and neuropsychiatric disorders. 35 Lumateperone is the first in class selective and simultaneous modulator of dopamine, serotonin, and glutamate, 5,18,22,30,32,[36][37][38][39][40][41] approved by the US Food and Drug Administration for the treatment of schizophrenia. 42…”

Section: Data Sources and Searchesmentioning

confidence: 99%

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The role of lumateperone in the treatment of schizophrenia

Syed

Brašić

2021

Therapeutic Advances in Psychopharmacology

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Schizophrenia is a devastating mental disorder resulting in marked morbidity and mortality despite the optimal use of all currently available interventions. For this reason, the release of lumateperone (CaptylaR), also known as ITI-007, an orally administered, atypical antipsychotic provided a welcome novel tool for clinicians to utilize precision medicine to tailor an optimal treatment plan to the specific needs of each person with schizophrenia. To generate a foundation for clinicians to assess the risks and benefits of lumateperone in relation to other interventions for schizophrenia, we conducted a search of items for ‘ITI-007’ and ‘lumateperone’ on PubMed, ScienceDirect, Web of Science, Google Scholar, and www.clinicaltrials.gov . We present a critical evaluation of the limited information about lumateperone for schizophrenia, its use approved by the US Food and Drug Administration. Lumateperone merits consideration for patients with treatment-resistant schizophrenia and for patients with schizophrenia who are vulnerable to developing metabolic dysfunction and movement disorders. On the other hand, lumateperone should not be used for (a) women who are pregnant or breastfeeding, children, adolescents, and elderly patients with dementia-related psychosis, (b) patients who are at risk for cerebrovascular diseases, (c) patients who use inducers and moderate or strong inhibitors of the cytochrome P450-3A4 (CYP3A4) isozyme, and (d) patients who use alcohol and other sedating agents. Clinical trials from multiple centers without financial conflicts of interest to market lumateperone are needed to directly compare and contrast lumateperone and other antipsychotic agents to generate trustworthy evidence to be assessed objectively by clinicians treating patients with schizophrenia. Future investigations will provide the foundations to identify the evidence for comprehensive evaluations of the role of lumateperone in the treatment of people with schizophrenia and other conditions.

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Pharmacological treatment of schizophrenia - a review of progress

Cited by 7 publications

References 36 publications

Less Medication Use in Inpatients With Severe Mental Illness Receiving a Multidisciplinary Lifestyle Enhancing Treatment. The MULTI Study III

Less Medication Use in Inpatients With Severe Mental Illness Receiving a Multidisciplinary Lifestyle Enhancing Treatment. The MULTI Study III

Traditional Chinese Medicine Decoction Combined With Antipsychotic for Chronic Schizophrenia Treatment: A Systematic Review and Meta-analysis

The role of lumateperone in the treatment of schizophrenia

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