Risk of Extrapyramidal Syndrome in Schizophrenic Patients Treated with Antipsychotics: A Population-based Study

Yang, Shang-Ju; Yang, Y-H Kao; Chong, Mian‐Yoon; Chang, Wen Ho; Lai, Chung-Sheng

doi:10.1038/sj.clpt.6100069

Cited by 42 publications

(33 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, it would be of great value to evaluate the Slack channel-modulating properties of loxapine and amoxapine hydroxylated derivatives. With respect to side effects, loxapine is known to be among the tricyclic antipsychotic agents most prone to inducing extrapyramidal syndrome (EPS), as shown by the very high rate of antiparkinsonism drug coprescription associated with loxapine use (Yang et al, 2007). Moreover, the study conducted by Yang et al (2007) confirmed previously published studies, supporting a quantitative correlation between the dosage administered and the EPS incidence rate (Ereshefsky, 1999).…”

Section: Downloaded Fromsupporting

confidence: 78%

The Antipsychotic Drug Loxapine Is an Opener of the Sodium-Activated Potassium Channel Slack (Slo2.2)

Biton

Sethuramanujam²,

Picchione³

et al. 2011

J Pharmacol Exp Ther

View full text Add to dashboard Cite

Sodium-activated potassium (K Na ) channels have been suggested to set the resting potential, to modulate slow afterhyperpolarizations, and to control bursting behavior or spike frequency adaptation (Trends Neurosci 28:422-428, 2005). One of the genes that encodes K Na channels is called Slack (Kcnt1, Slo2.2). Studies found that Slack channels were highly expressed in nociceptive dorsal root ganglion neurons and modulated their firing frequency (J Neurosci 30:14165-14172, 2010). Therefore, Slack channel openers are of significant interest as putative analgesic drugs. We screened the library of pharmacologically active compounds with recombinant human Slack channels expressed in Chinese hamster ovary cells, by using rubidium efflux measurements with atomic absorption spectrometry. Riluzole at 500 M was used as a reference agonist. The antipsychotic drug loxapine and the anthelmintic drug niclosamide were both found to activate Slack channels, which was confirmed by using manual patch-clamp analyses (EC 50 ϭ 4.4 M and EC 50 ϭ 2.9 M, respectively). Psychotropic drugs structurally related to loxapine were also evaluated in patch-clamp experiments, but none was found to be as active as loxapine. Loxapine properties were confirmed at the singlechannel level with recombinant rat Slack channels. In dorsal root ganglion neurons, loxapine was found to behave as an opener of native K Na channels and to increase the rheobase of action potential. This study identifies new K Na channel pharmacological tools, which will be useful for further Slack channel investigations.

show abstract

Section: Downloaded Fromsupporting

confidence: 78%

The Antipsychotic Drug Loxapine Is an Opener of the Sodium-Activated Potassium Channel Slack (Slo2.2)

Biton

Sethuramanujam²,

Picchione³

et al. 2011

J Pharmacol Exp Ther

View full text Add to dashboard Cite

show abstract

“…Olanzapine was administered as monotherapy in most studies of schizophrenia, except in a small number of prospective observational or retrospective studies 28–31. In these studies, combinations with other antipsychotics were specifically allowed or reflected the naturalistic setting of the study design.…”

Section: Resultsmentioning

confidence: 99%

“…30,31,35,37,66,69–79 Two studies also investigated the risk of pneumonia associated with second-generation antipsychotics, including olanzapine (Table 6). 28,33…”

Section: Resultsmentioning

confidence: 99%

Olanzapine in Chinese patients with schizophrenia or bipolar disorder: a systematic literature review

Xue

Liu

Zhang

et al. 2014

NDT

View full text Add to dashboard Cite

BackgroundDespite the burden of schizophrenia and bipolar disorder in the Chinese population, country-specific data to guide practitioners regarding antipsychotic therapy are lacking. The primary aim of this systematic review was to examine evidence of the efficacy, effectiveness, and safety of olanzapine in Chinese populations.MethodsA systematic literature search was conducted using databases covering international and Chinese core journals using search terms related to schizophrenia and bipolar disorder, specified countries (People’s Republic of China, Hong Kong, Taiwan), and olanzapine treatment. Following initial screening, inclusion and exclusion criteria were applied to the search results to identify relevant studies from which data were extracted.ResultsA total of 489 publications were retrieved and 61 studies were identified for inclusion. Most studies were related to schizophrenia (n=54), with six studies related to bipolar disorder and one study related to both conditions. The quality of study methods and reporting in international journals was noticeably better than in Chinese language journals. Most studies included relatively small patient populations and were of short duration. The efficacy of olanzapine in Chinese populations was confirmed by multiple comparative and noncomparative studies that found statistically significant reductions in symptom measures in studies conducted for ≥6 weeks (schizophrenia) or ≥3 weeks (bipolar disorder). Findings related to effectiveness (treatment discontinuation, quality of life, and neurocognitive improvements) were generally consistent with those observed in non-Chinese populations. No new safety signals specific for Chinese populations were raised for olanzapine.ConclusionChinese and non-Chinese populations with schizophrenia or bipolar disorder treated with olanzapine display broadly similar responses. Differences between these populations, especially in relation to the relative efficacy of olanzapine versus other antipsychotics, may warrant further investigation via studies incorporating both populations. Use of local data to provide evidence for practice guidelines should be encouraged, and may promote ongoing improvements in the quality of research and study reporting.

show abstract

“…Briefly, it tests the propensity to initiate a marker drug (e.g., trihexyphenidyl) after use of an index drug (e.g., antipsychotics), where the index drug is suspected inducing a side effect (e.g., extrapyramidal symptom) that warrants treatment with the marker drug [22]. Theoretically, if there is no causal relationship between index and marker drugs, it is equally possible for patients to initiate the marker drug before or after index drug initiation; resulting in a symmetrical (or random) prescribing pattern of the marker drug around index drug initiation.…”

Section: Methodsmentioning

confidence: 99%

Detecting Potential Adverse Reactions of Sulpiride in Schizophrenic Patients by Prescription Sequence Symmetry Analysis

et al. 2014

View full text Add to dashboard Cite

PurposePrevious studies have demonstrated sulpiride to be significantly more effective than haloperidol, risperidone and olanzapine in schizophrenic treatment; however, only limited information is available on the potential risks associated with sulpiride treatment. This study attempts to provide information on the potential risks of sulpiride treatment of schizophrenia, especially with regard to unexpected adverse effects.Materials and MethodsPatients with schizophrenia aged 18 and older, newly prescribed with a single antipsychotic medication from the National Health Insurance Research Database of Taiwan in the period from 2003 to 2010 were included. A within-subject comparison method, prescription sequence symmetry analysis (PSSA) was employed to efficiently identify potential causal relationships while controlling for potential selection bias.ResultsA total of 5,750 patients, with a mean age of 39, approximately half of whom were male, constituted the study cohort. The PSSA found that sulpiride was associated with EPS (adjusted SR, 1.73; 95% CI, 1.46–2.06) and hyperprolactinemia (12.04; 1.59–91.2). In comparison, EPS caused by haloperidol has a magnitude of 1.99 when analyzed with PSSA, and hyperprolactinemia caused by amisulpride has a magnitude of 8.05, respectively. Another finding was the unexpected increase in the use of stomatological corticosteroids, emollient laxatives, dermatological preparations of corticosteroids, quinolone antibacterials, and topical products for joint and muscular pain, after initiation of sulpiride treatment.ConclusionsWe found sulpiride to be associated with an increased risk of EPS and hyperprolactinemia, and the potential risk could be as high as that induced by haloperidol and amisulpride, respectively. Additionally, our study provides grounds for future investigations into the associations between sulpiride and the increased use of additional drugs for managing adverse effects, including stomatological, dermatological, and musculoskeletal or joint side effects, constipation, and pneumonia.

show abstract

Risk of Extrapyramidal Syndrome in Schizophrenic Patients Treated with Antipsychotics: A Population-based Study

Cited by 42 publications

References 56 publications

The Antipsychotic Drug Loxapine Is an Opener of the Sodium-Activated Potassium Channel Slack (Slo2.2)

The Antipsychotic Drug Loxapine Is an Opener of the Sodium-Activated Potassium Channel Slack (Slo2.2)

Olanzapine in Chinese patients with schizophrenia or bipolar disorder: a systematic literature review

Detecting Potential Adverse Reactions of Sulpiride in Schizophrenic Patients by Prescription Sequence Symmetry Analysis

Contact Info

Product

Resources

About