Randomized, Double-Blind Trial of Olanzapine Versus Placebo in Patients Prodromally Symptomatic for Psychosis

McGlashan, Thomas H.; Zipursky, Robert B.; Perkins, Diana O.; Addington, Jean; Miller, Tandy J.; Woods, Scott W.; Hawkins, Keith; Hoffman, Ralph E.; Preda, Adrian; Epstein, Irvin; Addington, Donald; Lindborg, Stacy; Trzaskoma, Quynh; Tohen, Mauricio; Breier, Alan

doi:10.1176/ajp.2006.163.5.790

Cited by 449 publications

(312 citation statements)

References 29 publications

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“…There have been a series of clinical trials of relatively small sample size examining both antipsychotics and/or cognitive therapy as preventive treatment strategies for ultra-high risk patients (60)(61)(62). These trials suggest that cognitive therapy and antipsychotics may prevent or at least delay the onset of psychotic disorder and reduce symptomatology.…”

Section: The Stages Of Early Psychosis Stage 1: Ultra-high Riskmentioning

confidence: 99%

“…These trials suggest that cognitive therapy and antipsychotics may prevent or at least delay the onset of psychotic disorder and reduce symptomatology. A second generation of single site clinical trials has recently been completed, with interesting results for a range of psychosocial and biological therapies, including cognitive therapy (62), lithium (63), omega-3 fatty acids (64), and atypical antipsychotics (60).…”

Section: The Stages Of Early Psychosis Stage 1: Ultra-high Riskmentioning

confidence: 99%

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Early intervention in psychosis: concepts, evidence and future directions

2008

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Section: The Stages Of Early Psychosis Stage 1: Ultra-high Riskmentioning

confidence: 99%

Section: The Stages Of Early Psychosis Stage 1: Ultra-high Riskmentioning

confidence: 99%

Early intervention in psychosis: concepts, evidence and future directions

2008

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“…Psychotherapy generally does not induce potentially harmful side effects. In contrast, medications such as the atypical antipsychotic olanzapine (which is frequently used as a mood stabilizer), while reducing rates of conversion to psychosis among at-risk teens, can be associated with substantial weight gain and the "metabolic syndrome" (McGlashan et al, 2006). Medications will probably have little effect on the intensity of external stressors, and will not buffer the at-risk person against stress once he or she has discontinued taking them.…”

Section: Psychosocial Intervention To Prevent or Delay The Onset Of Bdmentioning

confidence: 99%

Prevention of bipolar disorder in at-risk children: Theoretical assumptions and empirical foundations

Miklowitz

Chang

2008

Dev Psychopathol

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This article examines how bipolar symptoms emerge during development, and the potential role of psychosocial and pharmacological interventions in the prevention of the onset of the disorder. Early signs of bipolarity can be observed among children of bipolar parents and often take the form of subsyndromal presentations (e.g., mood lability, episodic elation or irritability, depression, inattention, and psychosocial impairment). However, many of these early presentations are diagnostically nonspecific. The few studies that have followed at-risk youth into adulthood find developmental discontinuities from childhood to adulthood. Biological markers (e.g., amygdalar volume) may ultimately increase our accuracy in identifying children who later develop bipolar I disorder, but few such markers have been identified. Stress, in the form of childhood adversity or highly conflictual families, is not a diagnostically-specific causal agent but does place genetically and biologically vulnerable individuals at risk for a more pernicious course of illness. A preventative family-focused treatment for children with (a) at least one first-degree relative with bipolar disorder, and (b) subsyndromal signs of bipolar disorder, is described. This model attempts to address the multiple interactions of psychosocial and biological risk factors in the onset and course of bipolar disorder.

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“…Las dosis deben ser bajas, por ejemplo risperidona 0,5-2 mg/día (96,97)0.5-2 mg/day u 5-15mg de olanzapina (98). No se recomienda su uso por tiempo prolongado debido al perfil de efectos adversos, principalmente el riesgo de síndrome metabólico.…”

Section: Antipsicóticos Atípicosunclassified

Estados clínicos de alto riesgo para esquizofrenia y otras formas de psicosis: una breve revisión.

2017

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RESUMENLa esquizofrenia y cuadros psicóticos relacionados son trastornos complejos que generalmente emergen en el período de transición de la adolescencia hacia la adultez, por lo que sus consecuencias pueden ser deletéreas y producir un alto número de años de vida perdidos por discapacidad. Un importante factor pronóstico es el tiempo transcurrido entre el inicio de la enfermedad y el inicio del tratamiento farmacológico, por lo que la detección temprana de la enfermedad es factor imprescindible. En esta revisión se examinan aspectos históricos, neurobiológicos y concepciones acerca de los estadios clínicos de alto riesgo para el desarrollo de esquizofrenia. En el ámbito de predicción clínica se presentan el modelo de los "síntomas básicos" de Huber y Gross, y el modelo de "criterios de riesgo ultra alto para esquizofrenia" de Mc Gorry y colaboradores. Se revisan los debates y resultados de abordajes tanto farmacológicos como psicoterapéuticos y se subraya claramente la necesidad de utilizar protocolos de detección de las fases preclínicas de esquizofrenia y otras psicosis en nuestro país.PALABRAS CLAVE: Esquizofrenia, espectro esquizofrénico, trastornos psicóticos, diagnóstico precoz. SUMMARYSchizophrenia and related psychotic conditions are complex disorders that generally emerge during the transition from adolescence to adulthood, so that their consequences may be deleterious and produce a high number of years of life lost due to disability. An important prognostic factor is the time elapsed between the onset of the disease and the beginning of pharmacological treatment, reason for which the early detection of the disease is an essential factor. This review examines historical aspects, neurobiological findings and conceptions about the high risk clinical stages for the development of schizophrenia. . In the field of clinical prediction, Huber and Gross' "basic symptoms" model, and Mc Gorry et al's "ultrahigh risk criteria for schizophrenia" model are presented. Debates about and results of both pharmacological and psychotherapeutic approaches are examined and the need to utilize detection protocols of the preclinical phases of schizophrenia and other psychoses in our country is strongly emphasized.

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Randomized, Double-Blind Trial of Olanzapine Versus Placebo in Patients Prodromally Symptomatic for Psychosis

Cited by 449 publications

References 29 publications

Early intervention in psychosis: concepts, evidence and future directions

Early intervention in psychosis: concepts, evidence and future directions

Prevention of bipolar disorder in at-risk children: Theoretical assumptions and empirical foundations

Estados clínicos de alto riesgo para esquizofrenia y otras formas de psicosis: una breve revisión.

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