The Brown University Psychopharmacology Update最新文献

A cohort study examining data for women giving birth in Hong Kong found no causal link between psychotropic drug exposure during pregnancy and risk of obstetric and neonatal complications. Risk of complications was similar between women who received psychotropics during pregnancy and those who discontinued use before becoming pregnant.

Aripiprazole is a third-generation antipsychotic with a unique pharmacological profile, exerting partial D₂ receptor agonism. It is metabolized primarily by the liver enzyme CYP2D6 and partially by CYP3A4 to its main metabolite, dehydro-aripiprazole. As a result of genetic inheritance of different allelic variants of the gene that controls CYP2D6 enzyme activity, that activity is significantly different among several CYP2D6 phenotypes: normal metabolizers (NM) with normal enzyme activity, ultra-rapid metabolizers (UM) with high enzyme activity, intermediate metabolizers (IM) with reduced enzyme activity, and poor metabolizers (PM) with very low or complete absence of enzyme activity.

A study comparing the efficacy and tolerability of seven antipsy- chotics in the treatment of schizophrenia has concluded that olanzapine and risperidone were the most efficacious of the studied drugs. Olanzapine was associated with greater weight gain, however, while risperidone was associated with greater risk of hyperprolactinemia.

Food and Drug Administration approval of a once-monthly extended-release formulation of buprenorphine for the treatment of opioid use disorder (OUD) has established an option for improving treatment retention and promoting abstinence from opioid use. A rapid induction protocol in which patients receive a same-day dose of the injectable formulation could improve engagement in care for the highest-risk patients with OUD, including those who use fentanyl. Investigators conducted an open-label trial to compare rapid induction to a standard induction protocol in promoting treatment retention. The study enrolled patients at outpatient treatment centers in the United States and Canada who met DSM-5 criteria for moderate to severe OUD and had engaged in high-risk opioid use for at least five days a week in the previous four weeks. Individuals in the rapid induction protocol received sublingual buprenorphine 4 mg on day one of treatment, with a first injection of extended-release buprenorphine an hour later if they showed no signs of precipitated opioid withdrawal and met other criteria. The standard induction group was dose-adjusted to sublingual buprenorphine for at least 7 days before receiving the extended-release formulation. The primary outcome was the between-group difference in treatment retention rates one week after the initial injection dose. Among the 723 randomized participants, the percentages of participants receiving a first and second injectable dose were 86.3% and 66.2%, respectively, in the rapid induction group and 59.2% and 54.1%, respectively, in the standard induction group. There were no significant between-group differences in the prevalence of adverse events. The study's authors wrote that the results “add to the evolving published evidence supporting effectiveness and safety of single-day buprenorphine initiation, with or without fentanyl use.” [Shiwach, R., et al. (2025). JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2025.37319]

Up to eight infusions of ketamine were not more effective than a psychoactive placebo in reducing depressive symptoms in patients receiving inpatient treatment for depression, a randomized trial has found. Patients receiving ketamine also showed no improvement relative to those receiving midazolam on measures of cognition and quality of life. Study results were published online Oct. 22, 2025 in JAMA Psychiatry.