Pub Date : 2010-08-01DOI: 10.1097/01.IDT.0000384050.93852.3e
M. Demitrack
clinical and economic burden of major depression; the compounding issue of treatment resistance; and cost analyses comparing transcranial magnetic stimulation (TMS) with standard clinical care (e.g., complex pharmacotherapy, electrconvulsive therapy [ECT]) for treatmentresistant depression (TRD). Part II reviews practical issues in the clinical use of TMS, which have emerged since its approval by the FDA for this indication.
{"title":"Transcranial Magnetic Stimulation for the Treatment of Major Depression: Clinical, Economic, and Practical Issues Part II","authors":"M. Demitrack","doi":"10.1097/01.IDT.0000384050.93852.3e","DOIUrl":"https://doi.org/10.1097/01.IDT.0000384050.93852.3e","url":null,"abstract":"clinical and economic burden of major depression; the compounding issue of treatment resistance; and cost analyses comparing transcranial magnetic stimulation (TMS) with standard clinical care (e.g., complex pharmacotherapy, electrconvulsive therapy [ECT]) for treatmentresistant depression (TRD). Part II reviews practical issues in the clinical use of TMS, which have emerged since its approval by the FDA for this indication.","PeriodicalId":90307,"journal":{"name":"Psychopharm review : timely reports in psychopharmacology and device-based therapies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.IDT.0000384050.93852.3e","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61611931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-07-01DOI: 10.1097/01.IDT.0000377465.94323.2d
A. Kledzik, D. Dunn
der (ADHD) in children was analyzed in several epidemiologic studies and estimated to be approximately 7%. Follow-up studies estimate that 60% to 85% of these children will meetADHD criteria as teenagers. Several algorithms guide treatment of ADHD, including the American Association of Child and Adolescent Psychiatry Practice Parameters for ADHD and the Texas Department of Health Services MedicationAlgorithm Project. Medications, including D,L-methylphenidate (MPH), dextroamphetamine, mixed amphetamine salts, and atomoxetine are FDA approved for the treatment of ADHD and considered first-line treatments. In several studies, these agents were very effective in treating symptoms ofADHD,with clinical response rates of up to 70% versus 4% to 30% with placebo. The effect size of stimulant treatment relative to placebo is 1.0. MPH and amphetamine preparations were compared and found equal in efficacy. Long-acting formulations are equal in efficacy to immediaterelease preparations and have the advantage of increasing adherence with once-daily dosing. Dosage may be titrated to After participating in this activity, the psychiatrist should be better able to:
在几项流行病学研究中分析了儿童的der (ADHD)，估计约为7%。后续研究估计，这些儿童中有60%至85%在青少年时期符合adhd标准。有几种算法指导多动症的治疗，包括美国儿童和青少年精神病学协会多动症实践参数和德克萨斯州卫生服务部门药物算法项目。药物，包括D, l -哌醋甲酯(MPH)，右旋安非他明，混合安非他明盐和托莫西汀是FDA批准用于治疗多动症的一线治疗方法。在几项研究中，这些药物在治疗多动症症状方面非常有效，临床反应率高达70%，而安慰剂的临床反应率为4%至30%。兴奋剂治疗相对于安慰剂的效应量为1.0。MPH和安非他明制剂比较，发现疗效相等。长效制剂的疗效与立即释放制剂相同，并且具有每日一次给药增加依从性的优点。参加此活动后，精神科医生应能更好地:
{"title":"Treatment of Attention Deficit Hyperactivity Disorder in Children With Medical Comorbidities","authors":"A. Kledzik, D. Dunn","doi":"10.1097/01.IDT.0000377465.94323.2d","DOIUrl":"https://doi.org/10.1097/01.IDT.0000377465.94323.2d","url":null,"abstract":"der (ADHD) in children was analyzed in several epidemiologic studies and estimated to be approximately 7%. Follow-up studies estimate that 60% to 85% of these children will meetADHD criteria as teenagers. Several algorithms guide treatment of ADHD, including the American Association of Child and Adolescent Psychiatry Practice Parameters for ADHD and the Texas Department of Health Services MedicationAlgorithm Project. Medications, including D,L-methylphenidate (MPH), dextroamphetamine, mixed amphetamine salts, and atomoxetine are FDA approved for the treatment of ADHD and considered first-line treatments. In several studies, these agents were very effective in treating symptoms ofADHD,with clinical response rates of up to 70% versus 4% to 30% with placebo. The effect size of stimulant treatment relative to placebo is 1.0. MPH and amphetamine preparations were compared and found equal in efficacy. Long-acting formulations are equal in efficacy to immediaterelease preparations and have the advantage of increasing adherence with once-daily dosing. Dosage may be titrated to After participating in this activity, the psychiatrist should be better able to:","PeriodicalId":90307,"journal":{"name":"Psychopharm review : timely reports in psychopharmacology and device-based therapies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.IDT.0000377465.94323.2d","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61611921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-06-01DOI: 10.1097/01.IDT.0000372139.52401.97
E. Liffick, A. Breier
approximately 1% of the world’s population. It is characterized by abnormal perceptual experiences, lack of expressiveness, social withdrawal, and cognitive difficulties. Onset of the disease typically occurs in late adolescence to early adulthood with prodromal symptoms—those being present prior to diagnosis of overt illness—noted years earlier in some patients. During these critical years of social, academic, and vocational development, many individuals with schizophrenia experience symptoms that hinder their ability tomeet personal goals. Symptomsmay be both terrifying and disabling. The disease is also associated with significant social costs. These include high rates of suicide, incarceration, unemployment, homelessness, and substance abuse. An additional concern is the life-shortening capacity of the disorder, primarily from cardiovascular disease and suicide. Individuals with schizophrenia have up to a 20% reduction in life expectancy comparedwith the general population. Given the substantial clinical and societal burden associated with schizophrenia, new approaches to manage this illness are urgently needed. After completing this CME activity, clinicians should be able to provide evidence based treatment for individuals early in the course of a psychotic illness.
{"title":"Pharmacotherapy of First‐Episode Schizophrenia","authors":"E. Liffick, A. Breier","doi":"10.1097/01.IDT.0000372139.52401.97","DOIUrl":"https://doi.org/10.1097/01.IDT.0000372139.52401.97","url":null,"abstract":"approximately 1% of the world’s population. It is characterized by abnormal perceptual experiences, lack of expressiveness, social withdrawal, and cognitive difficulties. Onset of the disease typically occurs in late adolescence to early adulthood with prodromal symptoms—those being present prior to diagnosis of overt illness—noted years earlier in some patients. During these critical years of social, academic, and vocational development, many individuals with schizophrenia experience symptoms that hinder their ability tomeet personal goals. Symptomsmay be both terrifying and disabling. The disease is also associated with significant social costs. These include high rates of suicide, incarceration, unemployment, homelessness, and substance abuse. An additional concern is the life-shortening capacity of the disorder, primarily from cardiovascular disease and suicide. Individuals with schizophrenia have up to a 20% reduction in life expectancy comparedwith the general population. Given the substantial clinical and societal burden associated with schizophrenia, new approaches to manage this illness are urgently needed. After completing this CME activity, clinicians should be able to provide evidence based treatment for individuals early in the course of a psychotic illness.","PeriodicalId":90307,"journal":{"name":"Psychopharm review : timely reports in psychopharmacology and device-based therapies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.IDT.0000372139.52401.97","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61612305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-05-01DOI: 10.1097/01.IDT.0000371059.45965.88
Frank P Macmaster, David R Rosenberg
{"title":"Glutamate and the Treatment of Obsessive-Compulsive Disorder.","authors":"Frank P Macmaster, David R Rosenberg","doi":"10.1097/01.IDT.0000371059.45965.88","DOIUrl":"https://doi.org/10.1097/01.IDT.0000371059.45965.88","url":null,"abstract":"","PeriodicalId":90307,"journal":{"name":"Psychopharm review : timely reports in psychopharmacology and device-based therapies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.IDT.0000371059.45965.88","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32180441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-05-01DOI: 10.1097/01.IDT.0000371058.38341.b3
F. Macmaster, D. Rosenberg
public health problem. Patients suffering from OCD have distressing obsessions and compulsions that impair their daily functioning. This severe and chronically debilitating disorder affects more than 3 million people in the United States. Estimates of the lifetime prevalence of OCD in pediatric and adult populations range from 1% to 3%. According to the World Health Organization, OCD is among the 10 most disabling medical conditions worldwide. Among anxiety disorders, the National Comorbidity Survey Replication states that OCD has the highest percentage (50.6%) of serious cases. The clinical phenomenology and nosology of pediatric OCD are well described. This makes OCD a leading candidate for innovative developmental neurobiological study. In contrast to major depression and bipolar disorder, the clinical presentation in childhood and adulthood is similar, making findings more applicable across the age span. The two reasons to focus our study and attention on pediatric OCD are:
{"title":"Glutamate and the Treatment of Obsessive‐Compulsive Disorder","authors":"F. Macmaster, D. Rosenberg","doi":"10.1097/01.IDT.0000371058.38341.b3","DOIUrl":"https://doi.org/10.1097/01.IDT.0000371058.38341.b3","url":null,"abstract":"public health problem. Patients suffering from OCD have distressing obsessions and compulsions that impair their daily functioning. This severe and chronically debilitating disorder affects more than 3 million people in the United States. Estimates of the lifetime prevalence of OCD in pediatric and adult populations range from 1% to 3%. According to the World Health Organization, OCD is among the 10 most disabling medical conditions worldwide. Among anxiety disorders, the National Comorbidity Survey Replication states that OCD has the highest percentage (50.6%) of serious cases. The clinical phenomenology and nosology of pediatric OCD are well described. This makes OCD a leading candidate for innovative developmental neurobiological study. In contrast to major depression and bipolar disorder, the clinical presentation in childhood and adulthood is similar, making findings more applicable across the age span. The two reasons to focus our study and attention on pediatric OCD are:","PeriodicalId":90307,"journal":{"name":"Psychopharm review : timely reports in psychopharmacology and device-based therapies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.IDT.0000371058.38341.b3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61611586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-04-01DOI: 10.1097/01.IDT.0000369508.83887.DB
M. Demitrack
{"title":"Transcranial Magnetic Stimulation for the Treatment of Major Depression: Clinical, Economic, and Practical Issues Part I","authors":"M. Demitrack","doi":"10.1097/01.IDT.0000369508.83887.DB","DOIUrl":"https://doi.org/10.1097/01.IDT.0000369508.83887.DB","url":null,"abstract":"","PeriodicalId":90307,"journal":{"name":"Psychopharm review : timely reports in psychopharmacology and device-based therapies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.IDT.0000369508.83887.DB","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61611574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-03-01DOI: 10.1097/01.IDT.0000368372.20840.B5
J. Onate
ease that is often asymptomatic for decades. Three hundred million people worldwide and 3.2 million in the United States are estimated to be infected with hepatitis C virus (HCV), which is a single-stranded ribonucleic acid virus. It is a leading indication for liver transplantation worldwide and is associated with high rates of cirrhosis and hepatocellular carcinoma. Chronic, active hepatitis C is also associated with high rates of substance use and mood, anxiety, and personality disorders. Diagnosis is first established by screening for anti-HCV antibodies and confirmed with a viral load and genotyping. There are six genotypes and many subgroups of hepatitis C. Genotypes 1a and 1b are the most common in the United States, and genotypes 2 and 3 are responsible for most cases elsewhere in the world. Patients with severe mental illness are at high risk of infection, especially in the presence of comorbid substance use.Although intravenous drug use is the highest risk factor, use of crack cocaine also substantially increases the risk of hepatitis C transmission. Additionally, sex-trade involvement and impulsivity found in substance abusers promotes high-risk behaviors resulting in increased transmission of viral hepatitis, HIV, and other sexually transmitted diseases (Table 1). There is evidence of an unrecognized epidemic of hepatitis C in the population with severe mental illness. Because patients with chronic hepatitis C often have normal liver function tests (LFTs) and aminotransferase levels, those with any history of intravenous drug use, crack cocaine use, or high-risk sexual behavior should be offered screening. Infected patients need a complete medical evaluation to rule out hepatic insufficiency and hepatocellular carcinoma. Those with hepatitis C should also be educated regarding the risk factors for transmission and treatment After participating in this activity, the psychiatrist should be better able to:
{"title":"Use of Psychiatric Drugs in Patients With Hepatitis C Review and Recommendations","authors":"J. Onate","doi":"10.1097/01.IDT.0000368372.20840.B5","DOIUrl":"https://doi.org/10.1097/01.IDT.0000368372.20840.B5","url":null,"abstract":"ease that is often asymptomatic for decades. Three hundred million people worldwide and 3.2 million in the United States are estimated to be infected with hepatitis C virus (HCV), which is a single-stranded ribonucleic acid virus. It is a leading indication for liver transplantation worldwide and is associated with high rates of cirrhosis and hepatocellular carcinoma. Chronic, active hepatitis C is also associated with high rates of substance use and mood, anxiety, and personality disorders. Diagnosis is first established by screening for anti-HCV antibodies and confirmed with a viral load and genotyping. There are six genotypes and many subgroups of hepatitis C. Genotypes 1a and 1b are the most common in the United States, and genotypes 2 and 3 are responsible for most cases elsewhere in the world. Patients with severe mental illness are at high risk of infection, especially in the presence of comorbid substance use.Although intravenous drug use is the highest risk factor, use of crack cocaine also substantially increases the risk of hepatitis C transmission. Additionally, sex-trade involvement and impulsivity found in substance abusers promotes high-risk behaviors resulting in increased transmission of viral hepatitis, HIV, and other sexually transmitted diseases (Table 1). There is evidence of an unrecognized epidemic of hepatitis C in the population with severe mental illness. Because patients with chronic hepatitis C often have normal liver function tests (LFTs) and aminotransferase levels, those with any history of intravenous drug use, crack cocaine use, or high-risk sexual behavior should be offered screening. Infected patients need a complete medical evaluation to rule out hepatic insufficiency and hepatocellular carcinoma. Those with hepatitis C should also be educated regarding the risk factors for transmission and treatment After participating in this activity, the psychiatrist should be better able to:","PeriodicalId":90307,"journal":{"name":"Psychopharm review : timely reports in psychopharmacology and device-based therapies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.IDT.0000368372.20840.B5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61611517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-02-01DOI: 10.1097/01.IDT.0000366925.86837.fe
A. Niculescu, L. Hulvershorn
Psychiatry is a complex field of medicine in which a growing understanding of the underlying disease biology is not fully integrated into clinical practice.Diagnosis is based on subjective personal history and clinical criteria. The latter are chosen through a consensus process by committees of experts in the field, and encoded in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and its international homologue, the International Classification of Diseases. These criteria are re-evaluated and updated periodically, on average every two decades, although the pace is likely to accelerate. The lack of objective diagnostic tests and empirical data-based approaches to psychiatric classification are possible reasons for the relative lack of reproducibility in psychiatric clinical trials. After participating in this activity, the psychiatrist should be better able to:
{"title":"Toward Early, Personalized, Rational Polypharmacy In Psychiatry: A Tri‐Dimensional Approach","authors":"A. Niculescu, L. Hulvershorn","doi":"10.1097/01.IDT.0000366925.86837.fe","DOIUrl":"https://doi.org/10.1097/01.IDT.0000366925.86837.fe","url":null,"abstract":"Psychiatry is a complex field of medicine in which a growing understanding of the underlying disease biology is not fully integrated into clinical practice.Diagnosis is based on subjective personal history and clinical criteria. The latter are chosen through a consensus process by committees of experts in the field, and encoded in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and its international homologue, the International Classification of Diseases. These criteria are re-evaluated and updated periodically, on average every two decades, although the pace is likely to accelerate. The lack of objective diagnostic tests and empirical data-based approaches to psychiatric classification are possible reasons for the relative lack of reproducibility in psychiatric clinical trials. After participating in this activity, the psychiatrist should be better able to:","PeriodicalId":90307,"journal":{"name":"Psychopharm review : timely reports in psychopharmacology and device-based therapies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.IDT.0000366925.86837.fe","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61611480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-01-01DOI: 10.1097/01.IDT.0000365317.93432.c1
Jeffrey Rado, P. Janicak
of schizophrenia, many patients do not benefit from or tolerate currently available antipsychotics. Two emerging agents recently received FDA approval: asenapine (reviewed in our last issue) and iloperidone, the focus of this article. Iloperidone (Fanapt, Vanda Pharmaceuticals, Inc.) is a novel mixed 5-HT2a/D2 antagonist, similar to other second-generation antipsychotics (SGAs). After initially being turned down by the FDAin July 2008 because of concerns about its efficacy compared with risperidone, it was approved in May 2009 for the acute treatment of schizophrenia. The recommended dose range is 12–24 mg/d titrated over the first week to minimize the risk of orthostatic hypotension. A six-marker genotype is also provided to aid in predicting clinical response. This article reviews the mechanism of action of iloperidone, data supporting its use in schizophrenia, and its safety profile.
{"title":"A Novel Treatment Option for Schizophrenia","authors":"Jeffrey Rado, P. Janicak","doi":"10.1097/01.IDT.0000365317.93432.c1","DOIUrl":"https://doi.org/10.1097/01.IDT.0000365317.93432.c1","url":null,"abstract":"of schizophrenia, many patients do not benefit from or tolerate currently available antipsychotics. Two emerging agents recently received FDA approval: asenapine (reviewed in our last issue) and iloperidone, the focus of this article. Iloperidone (Fanapt, Vanda Pharmaceuticals, Inc.) is a novel mixed 5-HT2a/D2 antagonist, similar to other second-generation antipsychotics (SGAs). After initially being turned down by the FDAin July 2008 because of concerns about its efficacy compared with risperidone, it was approved in May 2009 for the acute treatment of schizophrenia. The recommended dose range is 12–24 mg/d titrated over the first week to minimize the risk of orthostatic hypotension. A six-marker genotype is also provided to aid in predicting clinical response. This article reviews the mechanism of action of iloperidone, data supporting its use in schizophrenia, and its safety profile.","PeriodicalId":90307,"journal":{"name":"Psychopharm review : timely reports in psychopharmacology and device-based therapies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.IDT.0000365317.93432.c1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61611467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-12-01DOI: 10.1097/01.IDT.0000363156.07272.2e
P. Janicak, Jeffrey Rado
of the two recently approved antipsychotics in the United States. A subsequent issue will report on iloperidone. Asenapine is the latest agent to receive FDAapproval for both the acute treatment of schizophrenia andmanic or mixed episodes associated with bipolar I disorder in adults. It is marketed in the United States under the trade name Saphris (Schering Corp.) and is administered sublingually (SL). The recommended starting and target dose for schizophrenia is 5 mg twice daily, and the recommended starting dose for bipolar I disorder is 10 mg twice daily. The safety of asenapine at doses greater than 10 mg SLBID has not been assessed in clinical trials. This review will consider asenapine’s neuroreceptor profile, the data to support its utility in managing various symptoms associated with these disorders, and how asenapinemay distinguish itself from other agents in its class. PHARMACODYNAMICS Asenapine is a dibenzo-oxepino pyrrole, possessing a unique structure and a “broader spectrum” of neuroreceptor activity with differing affinity and antagonistic properties from other agents in its class (e.g., risperidone, olanzapine) (Figure 1). In this context, it has affinity and specificity for various receptors, including:
{"title":"Asenapine: A Review of the Data","authors":"P. Janicak, Jeffrey Rado","doi":"10.1097/01.IDT.0000363156.07272.2e","DOIUrl":"https://doi.org/10.1097/01.IDT.0000363156.07272.2e","url":null,"abstract":"of the two recently approved antipsychotics in the United States. A subsequent issue will report on iloperidone. Asenapine is the latest agent to receive FDAapproval for both the acute treatment of schizophrenia andmanic or mixed episodes associated with bipolar I disorder in adults. It is marketed in the United States under the trade name Saphris (Schering Corp.) and is administered sublingually (SL). The recommended starting and target dose for schizophrenia is 5 mg twice daily, and the recommended starting dose for bipolar I disorder is 10 mg twice daily. The safety of asenapine at doses greater than 10 mg SLBID has not been assessed in clinical trials. This review will consider asenapine’s neuroreceptor profile, the data to support its utility in managing various symptoms associated with these disorders, and how asenapinemay distinguish itself from other agents in its class. PHARMACODYNAMICS Asenapine is a dibenzo-oxepino pyrrole, possessing a unique structure and a “broader spectrum” of neuroreceptor activity with differing affinity and antagonistic properties from other agents in its class (e.g., risperidone, olanzapine) (Figure 1). In this context, it has affinity and specificity for various receptors, including:","PeriodicalId":90307,"journal":{"name":"Psychopharm review : timely reports in psychopharmacology and device-based therapies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.IDT.0000363156.07272.2e","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61611451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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