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Immunosuppressants, rheumatic and gastrointestinal topics
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Rules of prescription are: use of a single neuroleptic agent, progressive increase of dosage, find the minimal dosing that is therapeutically optimal, administer the drug in divided doses (two or three times daily).
Holding Patients with Medication
Published in Paul Ian Steinberg, Psychoanalysis in Medicine, 2020
Attempts to use psychodynamic psychotherapy and psychoanalysis to treat severely disturbed individuals, including individuals with psychotic illness, are well documented (Arieti, 1955; Frosch, 1983; Marder, 2007; Searles, 1986; see also Chapter 4). These treatments make considerable demands on the patient to integrate a combination of secondary process and creative primary process thinking, which is challenging work for anyone (Dorpat & Miller, 1992). It is particularly difficult for these patients, with their limited capacity to recognize reality, to maintain an integrated sense of their identity and to contain their uncomfortable affects and impulses. A significant number of DTP patients appeared so stressed by the psychodynamic approach, or to suffer from symptoms so severe, that their ability to benefit from group therapy was compromised. A small dose of neuroleptic medication enabled them to function better in psychotherapy and to derive more benefit from it.
Puerperal Psychosis
Published in Diana Riley, Perinatal Mental Health, 2018
There are no consistent findings in postnatal mood disorder regarding serotonin or monoamine oxidase, although both may be affected by oestrogen levels. However, recent work has shown that the onset of affective puerperal psychosis is associated with increased sensitivity of dopamine receptors in the brain47. As increased dopamine activity is known to be associated with psychotic illness, and neuroleptic drugs act by blocking dopamine, this is the most encouraging work so far.
Occupational intervention in mental health hospitals: Study of contextual impact
Published in Scandinavian Journal of Occupational Therapy, 2023
Shani Volovik-Shushan, Terry Krupa, Yuval Bloch, Lena Lipskaya-Velikovsky
Thirty inpatients participated either in the OC intervention (the study group, N = 14) or the treatment as usual (the control group, N = 16). The sample size was calculated based on OTDL-R score known from the pilot study of the OC effectiveness [19]. The OTDL-R score was found to be indicative for neurocognitive, clinical and functional outcomes. For the calculation with a power of 80%, ES of 0.9 and a significance level of .05, the sample size was 16 participants in each group (GPower Software). The participants were people with schizophrenia (N = 21, 70%) or schizoaffective disorder (N = 9, 30%), aged 19–50 (M = 32.9, SD = 9.5), recruited during 2015–2016. Most of the participants were single (N = 23, 76.7%), male (N = 28, 75.7%), and half of them worked in a competitive employment before hospitalisation (N = 16, 53.3%). There were no differences between the study and control groups in the demographic and illness-related data as presented in Table 1. All study participants received neuroleptic medication for at least 4 weeks at enrolment and did not experience developmental or acquired neurological conditions, physical disabilities, or current substance/alcohol abuse co-occurring with the psychiatric diagnosis.
14-3-3 proteins at the crossroads of neurodevelopment and schizophrenia
Published in The World Journal of Biological Psychiatry, 2022
André S. L. M. Antunes, Verônica M. Saia-Cereda, Fernanda Crunfli, Daniel Martins-de-Souza
The development of neuroleptic drugs has undoubtedly transformed not only the treatment of schizophrenia, resulting in an amelioration of the positive symptoms for many patients but also the understanding of the disease mechanisms. However, the focus on the medication instead of the illness has limited the progress in our understanding of the aetiology of the disease. Lately, the field has seen a shift from the neurochemical paradigm to an ever-increasing recognition of the neurodevelopmental aspect of the disorder. Schizophrenia is now hypothesised to manifest as the result of multiple genetic and environmental risk factors that impact early brain development and the formation of adequate connectivity between brain circuits (Weinberger and Levitt 2011; Duchatel et al. 2019). It is now accepted that neurodevelopmental processes in humans are not restricted to the prenatal and early postnatal period. For instance, prefrontal cortex maturation extends beyond adolescence (Teffer and Semendeferi 2012) and brain myelination progresses from birth into early adulthood in a spatiotemporal manner (Paus et al. 2001; Williamson and Lyons 2018). The prefrontal cortex and the process of brain myelination have both been implicated with the pathology of schizophrenia (Gouvêa-Junqueira et al. 2020; Chini and Hanganu-Opatz 2021), yet, to date, studies of neurodevelopmental aspects and their risk of schizophrenia have mostly focussed on the prenatal and early postnatal years.
A safety evaluation of aripiprazole in the treatment of schizophrenia
Published in Expert Opinion on Drug Safety, 2020
Adrian Preda, Bryan B. Shapiro
Schizophrenia is a chronic mental illness, with an incidence of about 1:10,000/year, a prevalence of about 1% worldwide, and a lifetime risk of 1%. The dopaminergic hypothesis of schizophrenia leads to the development of first-generation antipsychotics, which have been the mainstay of treatment of schizophrenia, presumably working via a blockade of the D2 dopamine receptors [1–3]. While this mechanism of action has been shown to improve the positive psychotic symptoms of schizophrenia, dopamine antagonism does not improve schizophrenia negative symptoms or cognitive deficits, which significantly contribute to associated functional impairment and disability [4]. Further, D2 blockade commonly results in significant motor adverse effects including extrapyramidal symptoms (EPS) such as Parkinsonism, dystonia, and dyskinesia. In turn, the motor toxicity of typical neuroleptics significantly contributes to medication non-adherence and increases risk for relapse [5].