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Question: What Are the Latest Guidelines for Treating Individuals With Body Dysmorphic Disorder? 问题:治疗身体畸形障碍的最新指南是什么?
IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2025-01-01 Epub Date: 2024-11-22 DOI: 10.1097/JCP.0000000000001945
Katharine A Phillips
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引用次数: 0
Efficacy and Safety of Dose Increase From 40 mg/d to 80 mg/d of Lurasidone in Patients With Schizophrenia: A Post Hoc Analysis of Extension Trial. 精神分裂症患者鲁拉西酮剂量从40mg /d增加到80mg /d的有效性和安全性:一项扩展试验的事后分析
IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2025-01-01 Epub Date: 2024-12-02 DOI: 10.1097/JCP.0000000000001943
Hiroyoshi Takeuchi, Hiroyuki Uchida

Objectives: The primary objective of this study was to evaluate the efficacy and safety of increasing the dose of lurasidone from 40 mg/d to 80 mg/d in patients with schizophrenia.

Methods: This post hoc analysis focused on patients who completed a 6-week double-blind, placebo-controlled trial of lurasidone and transitioned to a subsequent 12-week open-label extension trial. Patients initially assigned to lurasidone (40 mg/d) or placebo during the double-blind trial (DBT-LUR group or DBT-PLA group, respectively) received lurasidone (40 mg/d) during the extension. Clinicians could increase the dose to 80 mg/d based on clinical judgment. The efficacy outcomes included the change in the Positive and Negative Syndrome Scale (PANSS) total score from the start to the end of the lurasidone (80 mg/d) treatment period. Safety outcome was the rate of newly emergent adverse events.

Results: Of 287 patients in the intention-to-treat population, 153 received an increased dose of lurasidone from 40 mg/d to 80 mg/d. Significant reductions in the PANSS total scores were observed in both groups (all P values, ≤0.001). Additionally, 35.9% of the DBT-LUR group and 40.0% of the DBT-PLA group achieved a ≥20% reduction in the PANSS total score. New adverse events emerged in 47.4% of the DBT-LUR group and 48.0% of the DBT-PLA group during the lurasidone (80 mg/d) treatment period.

Conclusions: Increasing the dose of lurasidone from 40 mg/d to 80 mg/d may be effective and well tolerated in patients with schizophrenia. Because of the lack of a control group and blinding, the results should be interpreted with caution.

目的:本研究的主要目的是评估精神分裂症患者鲁拉西酮剂量从40mg /d增加到80mg /d的有效性和安全性。方法:这项事后分析的重点是完成了为期6周的鲁拉西酮双盲、安慰剂对照试验并转入随后的12周开放标签扩展试验的患者。在双盲试验期间(分别为DBT-LUR组或DBT-PLA组)最初分配给卢拉西酮(40 mg/d)或安慰剂的患者在延长期间接受卢拉西酮(40 mg/d)。临床医生可根据临床判断将剂量增加至80 mg/d。疗效指标包括鲁拉西酮(80 mg/d)治疗开始至结束时阳性和阴性综合征量表(PANSS)总分的变化。安全性指标为新出现不良事件的发生率。结果:在意向治疗人群中的287例患者中,153例接受了鲁拉西酮剂量从40mg /d增加到80mg /d的治疗。两组患者PANSS总分均显著降低(P值均≤0.001)。此外,35.9%的DBT-LUR组和40.0%的DBT-PLA组的PANSS总分降低≥20%。在鲁拉西酮(80 mg/d)治疗期间,DBT-LUR组和DBT-PLA组的新不良事件发生率分别为47.4%和48.0%。结论:将卢拉西酮的剂量从40mg /d增加到80mg /d可能对精神分裂症患者有效且耐受性良好。由于缺乏对照组和盲法,结果应谨慎解释。
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引用次数: 0
Agitated Depression and the Potential Response to Gama-Amino Butyric Acid Agonist: A Case Series and Literature Review. 激动性抑郁和对γ -氨基丁酸激动剂的潜在反应:一个病例系列和文献综述。
IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2025-01-01 Epub Date: 2024-11-26 DOI: 10.1097/JCP.0000000000001935
Rawan Alhau, Motaz Rimawi, Izabela Zubrzycka, Yassir Mahgoub

Purpose/background: Agitated depression is a specific variant of depressive disorder characterized by marked psychomotor agitation, including prominent restlessness and pacing, intense anxiety, irritability, and insomnia. These symptoms can be severe, and patients might be at increased risk of suicide. Authors have suggested that agitated depression can worsen with the use of antidepressants but can respond to options such as electroconvulsive therapy (ECT), lithium, anticonvulsants, antipsychotics, and benzodiazepines. Appropriate identification of this variant of depressive disorder is essential for proper treatment, as some of these patients might be labeled as resistant to treatment due to the worsening or lack of response to several antidepressant trials.

Methods/procedure: Summary of 2 recent cases and literature review on agitated depression symptoms and treatment.

Finding/results: Our 2 patients presented with symptoms of depressed mood, increased anxiety, irritability, poor sleep, poor appetite, restlessness, rumination, indecisiveness, and psychosis. Both patients had worsening symptoms with the use of various antidepressants but improved with the use of lorazepam and olanzapine. We review literature describing this variant of depressive disorder and its suggested treatment.

Implication/conclusion: Agitated depression has been poorly characterized in the literature. The criteria suggested by Koukopoulos et al (Acta Psychiatr Scand. 2007;115:50-57) and the provisional criteria for melancholia, as indicated by Mahgoub et al (Front Psychiatry. 2024;15:1372136), might help recognize this variant of depressive disorder. These patients might have a poor response or worsen with the use of antidepressants while responding to options like gamma-amino butyric acid (GABA) agonists, antipsychotics, and ECT.

目的/背景:躁动性抑郁症是抑郁症的一种特殊变体,其特征是明显的精神运动性躁动,包括显著的不安和踱步、强烈的焦虑、易怒和失眠。这些症状可能很严重,患者自杀的风险可能会增加。作者认为,使用抗抑郁药会使激动性抑郁症恶化,但对电休克疗法(ECT)、锂、抗惊厥药、抗精神病药和苯二氮卓类药物等治疗也有效果。适当识别这种抑郁症的变体对于适当治疗至关重要,因为其中一些患者可能由于对几种抗抑郁药物试验的恶化或缺乏反应而被标记为对治疗有抵抗力。方法/程序:总结最近2例躁动性抑郁症状及治疗的文献资料。发现/结果:我们的2例患者表现为情绪抑郁、焦虑增加、易怒、睡眠差、食欲差、烦躁不安、反刍、优柔寡断和精神病。两例患者均在使用各种抗抑郁药后症状加重,但在使用劳拉西泮和奥氮平后症状有所改善。我们回顾了描述这种抑郁症变体及其建议治疗的文献。含义/结论:在文献中,焦虑性抑郁的特征很少。Koukopoulos等人(《精神病学学报》,2007;115:50-57)提出的标准和Mahgoub等人(《前沿精神病学》,2024;15:1372 - 136)提出的忧郁症临时标准可能有助于识别抑郁症的这种变体。这些患者在使用抗抑郁药的同时,对γ -氨基丁酸(GABA)激动剂、抗精神病药物和电痉挛疗法有反应,可能反应不佳或恶化。
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引用次数: 0
α-PVP Associated Psychosis: A Case Report. α-PVP相关精神病1例报告
IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-11-01 DOI: 10.1097/JCP.0000000000001918
Irene Perez-Sagaseta de Ilurdoz, Alicia Aparicio-Dominguez, Silvia Yelmo-Cruz, Cesar Cardenes-Moreno
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引用次数: 0
Myocarditis on Clozapine 50 mg/d in a Patient With Parkinson's Disease. 帕金森病患者服用氯氮平 50 毫克/天后出现心肌炎。
IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-11-01 DOI: 10.1097/JCP.0000000000001927
Luisa Skoble, Stephen Kutz, Joseph H Friedman
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引用次数: 0
Psychopharmacologic Laziness. 精神药理学上的懒惰
IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-11-01 Epub Date: 2024-10-24 DOI: 10.1097/JCP.0000000000001924
Anthony J Rothschild
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引用次数: 0
Clozapine-Associated Sialorrhea: A Literature Review. 氯氮平相关唾液:文献综述。
IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-11-01 DOI: 10.1097/JCP.0000000000001917
Gamze Gürcan, Berk Atalay, Ece Deveci

Background: Clozapine has demonstrated efficacy in treating treatment-resistant schizophrenia; however, it has a wide range of side effects. Sialorrhea is a common side effect of clozapine that causes the patient to withdraw from social life. This review aims to evaluate and summarize the prevalence, mechanism, risk factors, and management of clozapine-associated sialorrhea.

Procedures: The literature was explored for the prevalence, the mechanisms, the risk factors, and the management of sialorrhea. The following search strings and terms were used: "clozapine," "sialorrhea," "hypersalivation," "clozapine induced sialorrhea," and "clozapine induced hypersalivation".

Study results: Hypersalivation is one of the most common side effects of clozapine. Over the course of clozapine therapy, hypersalivation has been reported to have an incidence of 30% to -80%. Although different treatment approaches are applied on a case-by-case basis in the clinic, depending on the practitioners' preferences, there is a lack of clear guidelines for managing this common side effect that jeopardizes patients' social life.

Conclusions: It is important for healthcare professionals and patients that some clear treatment options for clozapine-associated sialorrhea are brought to the forefront and widely used, especially based on the research conducted to date.

背景:氯氮平在治疗难治性精神分裂症中已被证实有效;然而,它有广泛的副作用。唾液是氯氮平的常见副作用,导致患者退出社交生活。本综述旨在评估和总结氯氮平相关唾液漏的流行、机制、危险因素和管理。方法:对唾液的流行、机制、危险因素和处理进行文献探讨。使用以下搜索字符串和术语:“氯氮平”、“唾液”、“唾液分泌过多”、“氯氮平诱导唾液分泌过多”和“氯氮平诱导唾液分泌过多”。研究结果:多涎是氯氮平最常见的副作用之一。据报道,在氯氮平治疗过程中,唾液过多的发生率为30%至-80%。尽管根据医生的喜好,不同的治疗方法在临床的个案基础上被应用,但缺乏明确的指导方针来管理这种危害患者社交生活的常见副作用。结论:对于医疗保健专业人员和患者来说,一些明确的氯氮平相关唾液病治疗方案被带到最前沿并被广泛使用是很重要的,特别是基于迄今为止的研究。
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引用次数: 0
Antipsychotic Polypharmacy in Time Course: Evidence for a Cross-titration Trap. 抗精神病药物的时间过程:交叉滴定陷阱的证据。
IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-11-01 Epub Date: 2024-10-19 DOI: 10.1097/JCP.0000000000001916
Marc W H Lochmann van Bennekom, Harm J Gijsman, Joanna IntHout, Robbert Jan Verkes

Purpose/background: Antipsychotic polypharmacy (APP) is controversial yet applied in 20% of patients with psychotic disorders. We investigated indications for initiating and continuing APP, including the contribution of unfinished cross-titrations.

Methods/procedures: This 2-month study was part of a prospective study to reduce inappropriate APP in inpatients. With each new prescription resulting in APP, we asked the prescriber for the indication (eg, switching antipsychotics, sedation for agitation/sleep disorders, treatment refractoriness, other) and repeated this at 30 and 60 days. Secondary outcome was unfinished cross-titration at 60 days.

Findings/results: In a consecutive cohort of 55 patients, 80% diagnosed with schizophrenia, switching antipsychotics was the primary initial indication for APP in 31 of 55 patients (56%), followed by sedation in 12 of 55 patients (22%), and treatment refractoriness in 10 of 55 patients (18%). Overall, APP was discontinued after 30 days in 25 of 55 patients (45%) and after 60 days in 28 of 55 patients (51%). At 60 days, APP initiated for switching antipsychotics was ongoing in 9 of 31 patients (29%), APP initiated for sedation was ongoing in 8 of 12 patients (66%), and APP initiated for refractoriness was ongoing in 9 of 10 patients (90%). The initial indication for APP was maintained at 60 days in 21 of 27 patients (78%). Unfinished cross-titration occurred in 9 of 31 patients (29%) with APP initiated for switching antipsychotics.

Implications/conclusions: APP was initiated primarily because of cross-titration switching of antipsychotics. The reason for APP was generally maintained consistently over time, particularly when initiated for treatment refractoriness. Of all patients with APP initiated to switch antipsychotics, 29% ended in unfinished cross-titration.

目的/背景:抗精神病药物多药治疗(APP)备受争议,但仍有 20% 的精神病患者使用这种治疗方法。我们对启动和继续使用 APP 的适应症进行了调查,包括未完成交叉滴定的贡献:这项为期 2 个月的研究是一项前瞻性研究的一部分,旨在减少住院患者不适当使用 APP 的情况。对于每个导致APP的新处方,我们都会询问处方开具者的适应症(如更换抗精神病药物、镇静治疗躁动/睡眠障碍、治疗难治性、其他),并在30天和60天后重复这一过程。次要结果是60天时未完成交叉治疗:在55名患者(80%确诊为精神分裂症)的连续队列中,55名患者中有31名患者(56%)最初使用APP的主要原因是更换抗精神病药物,其次是镇静,55名患者中有12名患者(22%)使用了APP,55名患者中有10名患者(18%)使用了APP。总体而言,55 名患者中有 25 人(45%)在 30 天后停用了 APP,55 名患者中有 28 人(51%)在 60 天后停用了 APP。60天后,31名患者中有9名(29%)因更换抗精神病药物而继续使用APP,12名患者中有8名(66%)因镇静而继续使用APP,10名患者中有9名(90%)因难治性而继续使用APP。27 名患者中有 21 名(78%)在 60 天后仍保留了最初的 APP 适应症。在31例因更换抗精神病药物而使用APP的患者中,有9例(29%)未完成交叉治疗:启动APP的主要原因是交叉滴定转换抗精神病药物。使用APP的原因通常会随着时间的推移而保持一致,尤其是在因治疗难治而启动APP的情况下。在所有因更换抗精神病药物而使用APP的患者中,29%的患者最终未完成交叉治疗。
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引用次数: 0
Aripiprazole-Associated QT Prolongation in a Healthy Study Volunteer: A Case Report and Literature Review. 一名健康研究志愿者的阿立哌唑相关 QT 延长:病例报告与文献综述
IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-11-01 Epub Date: 2024-10-24 DOI: 10.1097/JCP.0000000000001921
George E Chapman, Martin Osugo, Antonio de Marvao, Oliver D Howes
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引用次数: 0
Author Index 2024. 作者索引2024。
IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-11-01 DOI: 10.1097/JCP.0000000000001931
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引用次数: 0
期刊
Journal of Clinical Psychopharmacology
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