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Atypical Antipsychotic Drugs (atypical + antipsychotic_drug)

Distribution by Scientific Domains

Medical Sciences	81%
Life Sciences	18%

Distribution within Medical Sciences

Psychiatry	38%
Diabetes	22%

Selected Abstracts

Incorporating Evidence From Pharmacologic and Pharmacogenetic Studies of Atypical Antipsychotic Drugs Into Advanced Psychiatric Nursing Practice

PERSPECTIVES IN PSYCHIATRIC CARE, Issue 2 2010
Marilyn A. Davies PhD
PURPOSE., To present a conceptual framework for incorporating pharmacologic findings and pharmacogenetic evidence related to atypical antipsychotic drugs (AADs) into advanced psychiatric nursing practice. CONCLUSIONS., Three evidence domains lend important information about differential AAD response. These include the pharmacology of AADs, the molecular genetics of metabolizing enzymes, and the molecular genetics of neurotransmitter receptor drug targets. PRACTICE IMPLICATIONS., These evidence domains can be incorporated into nursing practice decisions related to medication planning, patient and family education, and medication monitoring processes. The central focus of the framework is patient outcomes, which include medication adherence, tolerability of the AADs, and demonstrated clinical effectiveness. [source]

Delusion and desire: erotomania revisited

ACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2000
B. D. Kelly
Objective: This paper examines the phenomonology in a case of erotomania and reviews classical and contemporary treatment options. Method: A case of primary erotomania is described. Results: Treatment with hospitalization and risperidone produced rapid clinical improvement. Conclusion: Atypical antipsychotic drugs may be useful in the treatment of this interesting syndrome. [source]

Protective effects of atypical antipsychotic drugs on PC12 cells after serum withdrawal

JOURNAL OF NEUROSCIENCE RESEARCH, Issue 2 2002
Ou Bai
Abstract Atypical antipsychotic drugs are widely used in the treatment of schizophrenia, and clinical evidence has shown that early and prolonged intervention with these drugs will improve the long-term outcome. It is still unclear, however, whether the atypical antipsychotic drugs are also neuroprotective. To clarify this matter, we used PC12 cell cultures and the MTT assay for cell viability to determine whether various concentrations of the atypical antipsychotics clozapine, quetiapine, and risperidone are neuroprotective after serum withdrawal. In addition, to explore the drugs' actions, Northern blot was used to examine the gene expression of SOD1 (Cu/Zn superoxide dismutase) and p75NTR (p75 neurotrophin receptor). The results demonstrated that 1) the antipsychotic drugs can protect PC12 cells from death after serum withdrawal; cell viability in these drug treatment groups is significantly different from that in the groups without serum in the medium (P < 0.01); and 2) these drugs up-regulated the SOD1 gene expression to more than 120% (P < 0.05) and also down-regulated p75NTR mRNA levels to less than 65% of their respective control values (P < 0.05). These findings suggest that the atypical antipsychotics clozapine, quetiapine, and risperidone may exert a neuroprotective function through the modulation of SOD1 and p75NTR expression. © 2002 Wiley-Liss, Inc. [source]

Atypical antipsychotic drugs and diabetes

PRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 9 2003
Dr C Livingstone BSc, MBChB, MRCPath Consultant Chemical Pathologist
Abstract The atypical antipsychotic drugs have enhanced the quality of life in many patients with schizophrenia. Their main advantage over conventional antipsychotic drugs is their propensity to cause fewer extrapyramidal adverse effects. However, there is increasing evidence that atypical antipsychotic drugs are associated with metabolic adverse effects including weight gain, new onset diabetes (both type 2 diabetes and diabetic ketoacidosis) and hypertriglyceridaemia. These problems are most common with clozapine. We discuss the mechanism of the association and recommendations for screening and monitoring in order that metabolic problems can be detected and treated early. Copyright © 2003 John Wiley & Sons, Ltd. [source]

Amisulpride: a review of its efficacyin schizophrenia

ACTA PSYCHIATRICA SCANDINAVICA, Issue 400 2000
H. J. Möller
Objective: To assess the efficacy of the new atypical antipsychotic drug, amisulpride. Method: Studies comparing the efficacy of amisulpride with that of haloperidol and risperidone, respectively, are reviewed. Outcome measures were Clinical Global Impression, Brief Psychiatric Rating Scale (BPRS), and Positive And Negative Symptom Scale (PANSS) scores. Results: Amisulpride was at least as effective as haloperidol and risperidone in the improvement of positive symptoms, and significantly more efficacious than haloperidol in reducing PANSS negative subscores (P=0.038) in patients with acute exacerbations. Amisulpride demonstrated a greater improvement in BPRS total scores (P<0.05) and PANSS negative subscores (P=0.0001) than haloperidol after 12 months of treatment in chronic schizophrenic patients with acute exacerbations. Conclusion: Amisulpride can thus be considered for use as first-line treatment of acute and chronic schizophrenia. [source]

Comparison of methanol and acetonitrile as solvents for the separation of sertindole and its major metabolites by capillary zone electrophoresis

ELECTROPHORESIS, Issue 17 2005
Xavier Subirats
Abstract Sertindole (1-[2-[4-[5-chloro-1-(4-fluorophenyl)-1H -indol-3-yl]-1-piperidinyl]ethyl]-2-imidazolidinone), an atypical antipsychotic drug, was separated by capillary electrophoresis from its two main metabolites norsertindole and dehydrosertindole. The low solubility of the analytes in water (octanol-water partition coefficient is about 105) is overcome by the use of methanol (MeOH) and acetonitrile (ACN) as solvents for the background electrolyte (BGE). Mobilities were measured in BGEs with defined pH in a broad range. It was found that in MeOH the mobility of the analytes is mainly governed by acid,base equilibria, whereas in ACN other reactions like ion pairing and homoconjugation play a pronounced role and lead to a complex pattern of the mobility as function of the pH. However, separation can be obtained in less than 10,min in both solvent systems. [source]

Olanzapine in the Treatment of Refractory Migraine and Chronic Daily Headache

HEADACHE, Issue 6 2002
Stephen D. Silberstein MD
Background.,Olanzapine, a thienobenzodiazepine, is a new "atypical" antipsychotic drug. Olanzapine's pharmacologic properties suggest it would be effective for headaches, and its propensity for inducing acute extrapyramidal reactions or tardive dyskinesia is relatively low. We thus decided to assess the value of olanzapine in the treatment of chronic refractory headache. Methods.,We reviewed the records of 50 patients with refractory headache who were treated with olanzapine for at least 3 months. All previously had failed treatment with at least four preventative medications. The daily dose of olanzapine varied from 2.5 to 35 mg; most patients (n = 19) received 5 mg or 10 mg (n = 17) a day. Results.,Treatment resulted in a statistically significant decrease in headache days relative to baseline, from 27.5 ± 4.9 before treatment to 21.1±10.7 after treatment (P < .001, Student t test). The difference in headache severity (0 to 10 scale) before treatment (8.7±1.6) and after treatment (2.2 ± 2.1) was also statistically significant (P < .001). Conclusion.,Olanzapine may be effective for patients with refractory headache, including those who have failed a number of other prophylactic agents. Olanzapine should receive particular consideration for patients with refractory headache who have mania, bipolar disorder, or psychotic depression or whose headaches previously responded to other neuroleptic medications. [source]

Perospirone in the treatment of patients with delirium

PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 1 2007
TAKASHI TAKEUCHI phd
Abstract, Perospirone is a recently developed atypical antipsychotic with potent serotonin 5-HT2 and dopamine D2 antagonist activity. Other atypical antipsychotics including risperidone, quetiapine and olanzapine have been widely used for treatment, not only for schizophrenia symptoms but also for delirium, because of their low potential to induce extrapyramidal disturbances. In the present study the effectiveness and safety of perospirone in patients with delirium are described. Thirty-eight patients with DSM-IV delirium were given open-label perospirone. To evaluate the usefulness of perospirone, scores from 13 severity items of the Delirium Rating Scale-Revised-98 were assessed. Data were gathered from October 2003 to September 2004. Perospirone was effective in 86.8% (33/38) of patients, and the effect appeared within several days (5.1 ± 4.9 days). The initial dose was 6.5 ± 3.7 mg/day and maximum dose of perospirone was 10.0 ± 5.3 mg/day. There were no serious adverse effects. However, increased fatigue (15.2%), sleepiness (6.1%), akathisia (3.0%) and a decline in blood pressure (3.0%) were observed. It is proposed that perospirone may be another safe and effective atypical antipsychotic drug for the treatment of delirium symptoms in hospitalized patients. This is a preliminary open trial, and further randomized double-blind placebo-controlled tests are needed. [source]

Torsade de pointes in a patient with complex medical and psychiatric conditions receiving low-dose quetiapine

ACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2005
W. V. R. Vieweg
Objective:, Describe potential cardiac complications of low-dose quetiapine and other atypical antipsychotic drugs. Method:, We present a case report of a 45-year-old Black woman with multiple medical and psychiatric problems taking low-dose quetiapine. Results:, Coincident with a generalized seizure, the patient developed ,ventricular fibrillation'. She was countershocked with restoration of normal sinus rhythm. The initial electrocardiogram showed QT interval prolongation. Shortly thereafter, classical torsade de pointes appeared, lasted 10 min, and resolved spontaneously. Hypomagnesemia was present. A cardiac electrophysiologist was concerned that the very slow shortening of the prolonged QTc interval after magnesium replacement implicated quetiapine as a risk factor for QTc interval prolongation and torsade de pointes. A psychosomatic medicine consultant asserted that the fragmented medical and psychiatric care almost certainly contributed to the patient's medical problems. We discuss other cases of QT interval prolongation by newer antipsychotic drugs and previous reports by our group concerning the association of psychotropic drugs, QT interval prolongation, and torsade de pointes. Conclusion:, Atypical antipsychotic drug administration, when accompanied by risk factors, may contribute to cardiac arrhythmias including torsade de pointes. [source]

Association between antipsychotic drugs and diabetes

DIABETES OBESITY & METABOLISM, Issue 2 2006
Richard I. G. Holt
The link between atypical antipsychotic drugs and the development of diabetes has been hotly debated in the literature. In this review, we attempt to classify the various types of data published and presented in a hierarchical basis. Case reports and retrospective pharmacoepidemiological studies suggest that both conventional and atypical antipsychotic medications are associated with an increased risk of glucose abnormalities or diabetes. Prospective data examining the relationship between atypical antipsychotic drugs and diabetes began to emerge in 2003 and are much less conclusive. Estimates of the attributable risk associated with atypical antipsychotic drugs are low. The few studies that have included a placebo group suggest that we cannot necessarily blame antipsychotic medication when diabetes develops in an individual with schizophrenia. [source]

Retrospective database analysis on the effectiveness of typical and atypical antipsychotic drugs in an outpatient clinic setting

HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 8 2007
Cengiz Akkaya
Abstract Objective To report the outcomes of a retrospective database analysis to compare the effectiveness of atypical and typical antipsychotic drugs. Methods Medical records of patients admitted to the psychiatry outpatient clinic between January 1998 and October 2005 were retrospectively reviewed. Data obtained from patient records were noted on a special form assessing four aspects of the treatment history: socio-demographic features, disease characteristics, initial treatment at the time of admission, and course of treatment. Patient groups (typical/atypical and Risperidone/Haloperidol/Olanzapine) were compared for time to all-cause medication discontinuation and rate of discontinuation. Results There was no statistically significant difference in the duration of treatment between patients using atypical (n,=,150) and typical (n,=,124) antipsychotics. The duration of treatment was significantly longer in patients on Haloperidol (n,=,91) compared with those on Risperidone (n,=,63). Rates of discontinuation over 18 months were 59.3% for patients on atypical antipsychotics and 57.3% for those on typical antipsychotics, and 68.3% for patients on Risperidone, 51.6% for patients on Haloperidol and 54.3% for patients on Olanzapine. Conclusion Despite our hypothesis patients with chronic schizophrenia discontinued their atypical and typical antipsychotics, at a high rate with no significant difference indicating substantial limitations in the effectiveness of these drugs. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Effects of zotepine and olanzapine on noradrenaline transporter in cultured bovine adrenal medullary cells

HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 7 2005
Reiji Yoshimura
Abstract Background Previously, it was demonstrated that the inhibitory effects of atypical antipsychotic drugs such as clozapine and risperidone on noradrenaline transporter (NAT) might in part be associated with their clinical profile. The present study examined the effects of zotepine on NAT in the cells and compared them with those of olanzapine. Materials and Methods Adrenal medullary cells were isolated by a method of collagenase digestion of slices of fresh bovine adrenal medulla and the cells were plated at a density of 4,×,106 cells. Cells were incubated with [3H]noradrenaline (NA) in the presence or absence of zotepine or olanzapine. The amount of radioactivity taken into the cells was counted by a liquid scintillation counter. Plasma membranes of bovine adrenal medulla were prepared, and the binding of [3H]desipramine (DMI) was determined by incubating the membrane suspension in binding buffer together with zotepine or olanzapine. Specific binding of [3H] DMI was defined as that binding which was inhibited by nisoxetine. Results Both zotepine (10,1000,ng/ml) and olanzapine (10,1000,ng/ml) decreased [3H]NA uptake in a concentration-dependent manner. The IC50 values of zotepine and olanzapine on [3H]NA uptake were 10,±,4 and 14,±,8,ng/ml, respectively. Eadie-Hofstee analysis of [3H]NA uptake showed that treatment with zotepine and olanzapine decreased the Vmax of uptake without changing the Km. Both zotepine (10,1000,ng/ml) and olanzapine (30,1000,ng/ml) inhibited [3H]DMI binding in a concentration-dependent manner. The IC50 values of zotepine and olanzapine on [3H]DMI binding were 50,±,18, and 120,±,38,ng/ml, respectively. Scatchard plot analysis of [3H]DMI binding showed that zotepine and olanzapine decreased the Bmax of binding without altering the Kd. Conclusions The inhibitory effects of zotepine and olanzapine might be responsible in part for their clinical profile. Copyright © 2005 John Wiley & Sons, Ltd. [source]

Protective effects of atypical antipsychotic drugs on PC12 cells after serum withdrawal

Incorporating Evidence From Pharmacologic and Pharmacogenetic Studies of Atypical Antipsychotic Drugs Into Advanced Psychiatric Nursing Practice

Variations in prescribing atypical antipsychotic drugs in primary care: cross-sectional study

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2002
Darren M. Ashcroft
Abstract Background Side-effects from conventional antipsychotic drugs, in particular extrapyramidal side-effects, limit their use for some patients, lead to non-compliance and may adversely affect the quality of life of others. Newer, more expensive, ,atypical' antipsychotics have been developed in attempts to address these problems, although debate about the most appropriate role for these medications remains. Objectives To examine variations in prescribing of the ,atypical' antipsychotics in primary care, over a 5-year period. Setting All 13 health authorities within the West Midlands region. Method Cross-sectional analysis of prescribing analysis and cost (PACT) data for atypical antipsychotic drugs (amisulpride, clozapine, olanzapine, risperidone, sertindole, and zotepine) was performed using one-way analysis of variance. To test whether the differences reflected variation in local population need, the prescribing data were adjusted using Mental Illness Needs Index scores. Regression analysis was used to examine the relationship between the overall levels of prescribing and local population need. Results The total volume of prescribing of atypical antipsychotic drugs in primary care increased nearly six-fold from 1996/97 to 2000/01 in the West Midlands region. Olanzapine was the most commonly prescribed drug during 1999/2000, accounting for 45% of defined daily doses, while risperidone accounted for 38% of the total. In 1996/97, a four-fold variation in rates of atypical antipsychotic prescribing between health authorities was found, compared with a three-fold variation in 2000/01, after adjusting for measures of local population need. Conclusions There has been a substantial increase in the prescription of atypical antipsychotics in primary care over the last 5 years, but the rate of increase has varied widely between health authorities. Further studies are needed to determine the factors that have led to these differences in uptake, and the likely impact of national guidance on future prescribing patterns. Copyright © 2002 John Wiley & Sons, Ltd. [source]

Atypical antipsychotic drugs and diabetes

The spectrum of subjective effects of antipsychotic medication

ACTA NEUROPSYCHIATRICA, Issue 5 2003
Hugo A Wolters
Background:, This study examined the spectrum of subjective experiences which patients attribute to the use of antipsychotic medication. Methods:, We collected interview data and answers to structured questions based on a comprehensive checklist in 77 patients using various types of classical or atypical antipsychotic drugs. Results:, The responses of the patients could be categorized into psychological and somatic domains. The psychological domain could be subdivided into emotional, cognitive and sociability domains. The somatic set could be subdivided into activation and physiological domains. Conclusions:, Our data reveal that the same effects may be experienced in either a positive or a negative way by different patients. We conclude that existing scales for measuring subjective effects of antipsychotic medication are incomplete. [source]

5-HT1A RECEPTOR AGONIST PROPERTIES OF ANTIPSYCHOTICS DETERMINED BY [35S]GTP,S BINDING IN RAT HIPPOCAMPAL MEMBRANES

CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 5-6 2007
Yuji Odagaki
SUMMARY 15-Hydroxytryptamine 1A (5-HT1A) receptors have attracted increasing attention as a promising target for antipsychotic therapy. Although many atypical antipsychotic drugs, including the prototype clozapine, have been reported to be partial agonists at 5-HT1A receptors, these results are often fragmental and derived mainly from experiments that used cultured cells. 2In the present study, [35S]guanosine 5,- O -(3-thiotriphosphate) ([35S]GTP,S) binding assay in rat hippocampal membranes was applied to a series of antipsychotic drugs, especially atypical antipsychotics. 3Most, but not all, of atypical antipsychotic drugs and the classical antipsychotic drug nemonapride behaved as partial agonists at 5-HT1A receptors with varied potencies and relative efficacies. The most potent compound was perospirone with a mean EC50 of 27 nmol/L, followed by aripiprazole (45 nmol/L) > ziprasidone (480 nmol/L) > nemonapride (790 nmol/L) > clozapine (3900 nmol/L) > quetiapine (26 000 nmol/L). The maximal percentage increases over the basal binding (%Emax) for these antipsychotic drugs were 30,50%, with the exception of perospirone (, 15%), whereas 5-HT stimulated the binding to a mean %Emax of 105%. 4Increasing concentrations of the selective and neutral 5-HT1A antagonist WAY100635 shifted the concentration,response curve of nemonapride-stimulated [35S]GTP,S binding to the right and in parallel. 5The relative efficacy or intrinsic activity of a compound was affected differently by the differing concentrations of guanosine diphosphate (GDP) in the assay buffer, which should be taken into consideration when determining the relative efficacies of these antipsychotics as 5-HT1A receptor agonists. 6These results provide important information concerning the relevance of 5-HT1A receptor partial agonist properties in the treatment for schizophrenic patients with most, if not all, of atypical antipsychotic drugs. [source]

Antipsychotic-induced weight gain

DIABETES OBESITY & METABOLISM, Issue 5 2005
A. J. Goudie
Abstract:, Novel ,atypical' antipsychotic drugs represent a substantial improvement on older ,typical' drugs. However, clinical experience has shown that some, but not all, of these drugs can induce substantial weight gain. This interferes with compliance with drug taking and has expected effects on morbidity and mortality. In this review, we summarize current thinking on: (i) the extent to which different ,atypical' drugs induce weight gain; (ii) the possible roles of various neurotransmitters and neuropeptides in this adverse drug reaction; and (iii) the state of development of animal models in this area. We also outline major areas for future research. [source]