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Lee ES, Kronsberg H, Findling RL. Psychopharmacologic Treatment of Schizophrenia in Adolescents and Children. Child Adolesc Psychiatr Clin N Am 2020; 29:183-210. [PMID: 31708047 DOI: 10.1016/j.chc.2019.08.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
An increasing number of antipsychotic medications have demonstrated efficacy in randomized placebo-controlled trials in the treatment of children and adolescents with schizophrenia. This review summarizes and synthesizes relevant antipsychotic medication studies, with particular emphasis on second-generation agents, and discusses other clinical considerations that may influence medication selection. With the exception of clozapine demonstrating superior efficacy in the improvement of psychotic symptoms in treatment-resistant patients, many antipsychotic agents have been shown to be similarly efficacious, including first-generation medications. Consideration of the side-effect profile, which can differ substantially from medication to medication, is essential when choosing treatment options.
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Affiliation(s)
- Esther S Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans Street, Bloomberg Children's Center, Suite 12344, Baltimore, MD 21287, USA.
| | - Hal Kronsberg
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans Street, Bloomberg Children's Center, Suite 12344, Baltimore, MD 21287, USA
| | - Robert L Findling
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans Street, Bloomberg Children's Center, Suite 12344, Baltimore, MD 21287, USA
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Shalbafan M, Saeedi V, Kamalzadeh L. Significant improvement of risperidone-induced retrograde ejaculation on drug holidays: a case report. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2019.1565694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
| | - Vahid Saeedi
- Pediatric Endocrinology and Metabolism Department of Hazrat-e Ali Asghar Pediatrics Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Kamalzadeh
- Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran
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Turk T, Hernandez Morfin N, Alkhatib M. Blonanserin versus risperidone for schizophrenia. Hippokratia 2017. [DOI: 10.1002/14651858.cd012587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Tarek Turk
- Damascus University; Faculty of Medicine; Mazzeh Street Damascus Syrian Arab Republic
| | | | - Mahmoud Alkhatib
- Damascus University; Faculty of Medicine; Mazzeh Street Damascus Syrian Arab Republic
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Roffman JL, Tanner AS, Eryilmaz H, Rodriguez-Thompson A, Silverstein NJ, Ho NF, Nitenson AZ, Chonde DB, Greve DN, Abi-Dargham A, Buckner RL, Manoach DS, Rosen BR, Hooker JM, Catana C. Dopamine D1 signaling organizes network dynamics underlying working memory. SCIENCE ADVANCES 2016; 2:e1501672. [PMID: 27386561 PMCID: PMC4928887 DOI: 10.1126/sciadv.1501672] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 05/11/2016] [Indexed: 05/04/2023]
Abstract
Local prefrontal dopamine signaling supports working memory by tuning pyramidal neurons to task-relevant stimuli. Enabled by simultaneous positron emission tomography-magnetic resonance imaging (PET-MRI), we determined whether neuromodulatory effects of dopamine scale to the level of cortical networks and coordinate their interplay during working memory. Among network territories, mean cortical D1 receptor densities differed substantially but were strongly interrelated, suggesting cross-network regulation. Indeed, mean cortical D1 density predicted working memory-emergent decoupling of the frontoparietal and default networks, which respectively manage task-related and internal stimuli. In contrast, striatal D1 predicted opposing effects within these two networks but no between-network effects. These findings specifically link cortical dopamine signaling to network crosstalk that redirects cognitive resources to working memory, echoing neuromodulatory effects of D1 signaling on the level of cortical microcircuits.
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Affiliation(s)
- Joshua L. Roffman
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA
- Corresponding author.
| | - Alexandra S. Tanner
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - Hamdi Eryilmaz
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - Anais Rodriguez-Thompson
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - Noah J. Silverstein
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - New Fei Ho
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - Adam Z. Nitenson
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - Daniel B. Chonde
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA
| | - Douglas N. Greve
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA
| | - Anissa Abi-Dargham
- Department of Psychiatry, Columbia University Medical Center, Harkness Pavilion, 180 Fort Washington Avenue, New York, NY 10032, USA
| | - Randy L. Buckner
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA
| | - Dara S. Manoach
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA
| | - Bruce R. Rosen
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA
| | - Jacob M. Hooker
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA
| | - Ciprian Catana
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA
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Hong J, Novick D, Brugnoli R, Karagianis J, Dossenbach M, Haro JM. Clinical consequences of switching from olanzapine to risperidone and vice versa in outpatients with schizophrenia: 36-month results from the Worldwide Schizophrenia Outpatients Health Outcomes (W-SOHO) study. BMC Psychiatry 2012; 12. [PMID: 23206324 PMCID: PMC3536691 DOI: 10.1186/1471-244x-12-218] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND With many atypical antipsychotics now available in the market, it has become a common clinical practice to switch between atypical agents as a means of achieving the best clinical outcomes. This study aimed to examine the impact of switching from olanzapine to risperidone and vice versa on clinical status and tolerability outcomes in outpatients with schizophrenia in a naturalistic setting. METHODS W-SOHO was a 3-year observational study that involved over 17,000 outpatients with schizophrenia from 37 countries worldwide. The present post hoc study focused on the subgroup of patients who started taking olanzapine at baseline and subsequently made the first switch to risperidone (n=162) and vice versa (n=136). Clinical status was assessed at the visit when the first switch was made (i.e. before switching) and after switching. Logistic regression models examined the impact of medication switch on tolerability outcomes, and linear regression models assessed the association between medication switch and change in the Clinical Global Impression-Schizophrenia (CGI-SCH) overall score or change in weight. In addition, Kaplan-Meier survival curves and Cox-proportional hazards models were used to analyze the time to medication switch as well as time to relapse (symptom worsening as assessed by the CGI-SCH scale or hospitalization). RESULTS 48% and 39% of patients switching to olanzapine and risperidone, respectively, remained on the medication without further switches (p=0.019). Patients switching to olanzapine were significantly less likely to experience relapse (hazard ratio: 3.43, 95% CI: 1.43, 8.26), extrapyramidal symptoms (odds ratio [OR]: 4.02, 95% CI: 1.49, 10.89) and amenorrhea/galactorrhea (OR: 8.99, 95% CI: 2.30, 35.13). No significant difference in weight change was, however, found between the two groups. While the CGI-SCH overall score improved in both groups after switching, there was a significantly greater change in those who switched to olanzapine (difference of 0.29 points, p=0.013). CONCLUSION Our study showed that patients who switched from risperidone to olanzapine were likely to experience a more favorable treatment course than those who switched from olanzapine to risperidone. Given the nature of observational study design and small sample size, additional studies are warranted.
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Affiliation(s)
- Jihyung Hong
- Personal Social Services Research Unit, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK.
| | - Diego Novick
- European Health Outcomes Research, Eli Lilly and Company, Windlesham, Surrey, UK
| | - Roberto Brugnoli
- Fondazione Italiana per lo studio della Schizophrenia, Rome, Italy
| | | | | | - Josep Maria Haro
- Parc Sanitari Sant Joan de Deu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
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Pfeifer JC, Kowatch RA, DelBello MP. Pharmacotherapy of bipolar disorder in children and adolescents: recent progress. CNS Drugs 2010; 24:575-93. [PMID: 20441242 DOI: 10.2165/11533110-000000000-00000] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Child and adolescent bipolar disorder (BPD) is a serious psychiatric disorder that often causes significant impairment in functioning. Pharmacological intervention is the cornerstone of treatment for bipolar youth, although psychotherapeutic interventions may be beneficial as adjunctive treatment. Medications used for the treatment of BPD in adults are still commonly used for bipolar children and adolescents. With the recent US FDA indication of risperidone, aripiprazole, quetiapine and olanzapine for the treatment of bipolar youth, the atypical antipsychotics are rapidly becoming a first-line treatment option. However, these agents are associated with adverse effects such as increased appetite, weight gain and type II diabetes mellitus. Although several evidence-based medications are now available for the treatment of BPD in younger populations, additional studies to evaluate the short- and long-term efficacy and potential for adverse events of these and other medications are needed.
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Affiliation(s)
- Jonathan C Pfeifer
- Division of Child Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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Davies MA, Conley Y, Roth BL. Functional SNPs in Genes Encoding the 5-HT2A Receptor Modify the Affinity and Potency of Several Atypical Antipsychotic Drugs. Biol Res Nurs 2010; 13:55-60. [DOI: 10.1177/1099800409358760] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Atypical antipsychotic drugs (AADs) are the standard treatment for both the acute and long-term management of schizophrenia and an augmentation to mood stabilizers for bipolar disorder (BD). Yet many individuals who take AADs do not fully respond to them, while others experience side effects that include weight gain and metabolic disorder. This in vitro pharmacogenetic study examined whether allelic variants in the 5-hydroxytryptamine (HT)2A receptor alter the in vitro pharmacology of six AADs (clozapine, olanzapine, risperidone, quetiapine, ziprasidone, and aripiprazole). We selected 4 functional single-nucleotide polymorphisms (SNPs) for investigation (Thr25Asn, Ile197Val, Ala447Val, and His452Tyr), conducted site-directed mutagenesis studies to induce variants into human HEK-293 cell lines, and screened allelic variants for their effects on 5-HT 2A receptors in the cell lines. We conducted numerous binding assays and fluorescence-based assay system (FLEX station) experiments using the six AADs. Our results indicated that three polymorphic 5-HT2A receptors (Ile197Val, Ala447Val, and His452Tyr) exhibited statistically significant, though modest, changes in atypical antipsychotic affinity. In addition, three polymorphic receptors (Thr25Asn, Ile197Val, and His452Try) altered AAD potency. Our findings support in vivo evidence that functional SNPs in genes encoding neuroreceptor drug targets could explain interindividual differences in AAD drug response and tolerability. We suggest that more in vivo pharmacogenetic studies of well-characterized patients who are prescribed AADs be indicated. Future pharmacogenetic studies of well-characterized patients will likely involve tagging SNPs and the use of haplotypes related to other genes encoding neuroreceptor drug targets.
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Affiliation(s)
- Marilyn A. Davies
- Department of Community and Health Systems, School of Nursing, University of Pittsburgh, PA, USA,
| | - Yvette Conley
- Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, PA, USA, Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, PA, USA
| | - Bryan L. Roth
- Department of Pharmacology, School of Medicine, University of North Carolina at Chapel Hill, USA
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A decade of progress in the discovery and development of 'atypical' antipsychotics. PROGRESS IN MEDICINAL CHEMISTRY 2010; 49:37-80. [PMID: 20855038 DOI: 10.1016/s0079-6468(10)49002-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Pfeifer JC, Kowatch RA, DelBello MP. The use of antipsychotics in children and adolescents with bipolar disorders. Expert Opin Pharmacother 2007; 8:2673-87. [DOI: 10.1517/14656566.8.16.2673] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Jonathan C Pfeifer
- The University of Cincinnati Medical Center, Cincinnati Children's Hospital Medical Center, Department of Psychiatry, MSB 7261, PO Box 670559, Cincinnati, Ohio 45267-0559, USA ;
| | - Robert A Kowatch
- The University of Cincinnati Medical Center, Cincinnati Children's Hospital Medical Center, Department of Psychiatry, MSB 7261, PO Box 670559, Cincinnati, Ohio 45267-0559, USA ;
| | - Melissa P DelBello
- The University of Cincinnati Medical Center, Cincinnati Children's Hospital Medical Center, Department of Psychiatry, MSB 7261, PO Box 670559, Cincinnati, Ohio 45267-0559, USA ;
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Recent Development in the Chemistry of Pyrido-oxazines, Pyrido-thiazines, Pyrido-diazines and Their Benzologs. Part 2. ADVANCES IN HETEROCYCLIC CHEMISTRY 2003. [DOI: 10.1016/s0065-2725(03)85003-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
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