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Psychocutaneous Disorders
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Kristen Russomanno, Vesna M. Petronic-Rosic
Second-generation antipsychotics (e.g., risperidone, olanzapine) have become the first-line treatment for delusions of parasitosis, and atypical antipsychotics have also been used successfully. In small case reports and case series, risperidone and olanzapine have shown to be effective and well tolerated. Risperidone is typically initiated at a dose of 0.25 or 0.5 mg/day and can be titrated up to 6 mg/day. Patients may require between 2–4 mg/day for symptom benefit, and at least partial response may be achieved within a few weeks to months of treatment. Initiation of olanzapine at a dose of 5 mg/day, titrated up to as high as 20 mg/day may be effective within 1–3 months. Severe side effects of second-generation antipsychotics include extrapyramidal symptoms, hyperprolactinemia, neuroleptic malignant syndrome, tardive dyskinesia, agranulocytosis, and metabolic syndrome. Baseline bloodwork and close monitoring are recommended.
Immunosuppressants, rheumatic and gastrointestinal topics
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Risperidone [43] is the drug that has been most studied, in several open studies. One recent controlled study, involving 101 children (82 boys and 19 girls) with a mean age of 8.8 years (± 2.7) over a period of 8 weeks, showed that 34 out the 49 children treated by risperidone (69%) were improved (irritability and temper tantrums), as opposed to 6 out of 52 (12%) in the placebo group. In two-thirds of the children with a positive response to risperidone at eight weeks, the benefit was maintained at six months. Increased appetite, fatigue, drowsiness, dizziness and drooling were more common in the risperidone group.
Prescribing for a first episode of schizophrenia-like psychosis
Published in Kathy J Aitchison, Karena Meehan, Robin M Murray, First Episode Psychosis, 2021
Kathy J Aitchison, Karena Meehan, Robin M Murray
Low-potency typical antipsychotics may cause an elevation of liver enzymes and cholestatic jaundice (the latter occurs in 0.1-0.5% of patients taking chlorpromazine). Jaundice usually occurs within the first month of treatment and requires discontinuation of treatment, investigation for other causes of jaundice and substitution of another agent with a lower likelihood of inducing this complication. Olanzapine can cause a transient rise in liver enzymes but this rarely persists or necessitates stopping the drug. Risperidone may cause nausea and abdominal pain.
Effect of risperidone on serum IL-6 levels in individuals with schizophrenia: a systematic review and meta-analysis
Published in International Journal of Psychiatry in Clinical Practice, 2023
Miguel Angel Ramos-Méndez, Carlos Alfonso Tovilla-Zárate, Isela Esther Juárez-Rojop, Mario Villar-Soto, Alma Delia Genis-Mendoza, Thelma Beatriz González-Castro, María Lilia López-Narváez, José Jaime Martínez-Magaña, Rosa Giannina Castillo-Avila, Guillermo Efrén Villar-Juárez
Risperidone is an antipsychotic drug used for the treatment of individuals diagnosed with schizophrenia (Noto et al., 2014). However, some studies have revealed that the use of this drug may have an immunomodulatory effect, altering the levels of proinflammatory cytokines such as IL-6 (Noto et al., 2019). IL-6 contributes in the normal brain function. For example, this cytokine intensified serotonergic and dopaminergic turnover in hypocampus and frontals cortex (Borovcanin et al., 2017; Day et al., 2014). Furthermore, IL-6 is involved in the increased levels of kynurenic acid and quinolinic acid; stimulating glutamatergic transmission (Borovcanin et al., 2017; Müller et al., 2013). IL-6 effects on neurotransmission catecholamines or glutamatergic system has been closely associated with onset and progression of schizophrenia (Borovcanin et al., 2017; Khandaker & Dantzer, 2016).
Comparing the efficacy of aripiprazole as an add-on to valproate with other second-generation antipsychotics in acute mania symptoms in manic patients in Iran
Published in International Journal of Psychiatry in Clinical Practice, 2022
Zeinab Sadat Ayatollahi, Mehran Shayganfard, Hamidreza Jamilian, Anita Alaghmand
In the intervention group, patients treated with aripiprazole received a basal dose of 5–15 mg per day, which was increased by 5 mg at weeks 2, 4 and 6 (maximum dose at the end of the 6th week: 30 mg per day) (Arnold et al. 2021). Risperidone treatment was initiated with 2–3 mg per day increased to the maximum dose of 6 mg per day (the dose elevation was not more than 1 mg per day). Firstly, olanzapine treatment was administered in 10–15 mg daily maximised to 20–25 mg daily at the end. 100 mg quetiapine was prescribed for the first day which was increased 100 mg per day until the fourth day (400 mg on the fourth day). Then, it was increased on days 5th and 6th (200 mg daily) reached 800 mg on the sixth day. Treatment with sodium valproate was started orally at a dose of 250 mg which was eventually increased to 1200–1500 mg daily in divided doses. To perform an equal treatment plan in both groups, the only mood stabiliser which was added over Aripiprazole or other second-generation antipsychotics was sodium valproate.
Current and emerging pharmacotherapeutic strategies for Tourette syndrome
Published in Expert Opinion on Pharmacotherapy, 2022
During the 1990s, the availability of new medications with better tolerability profiles resulted in decreased use of first-generation antidopaminergic medications, which were mainly replaced by second-generation antidopaminergic medications. Risperidone is a D2 dopamine receptor blocker as well as a 5-HT2 serotonin receptor antagonist at lower doses. Its spectrum of action also includes D3 and D4 dopaminergic, alpha-2 adrenergic, and H1 histaminergic receptors [41,42]. The effectiveness of risperidone in reducing tic severity has been thoroughly documented, together with its lower propensity to cause extrapyramidal adverse effects [39]. Weight gain, dyslipidemia, hyperglycemia, and hyperprolactinemia are well known metabolic adverse effects of risperidone [43]. Over the last decade, the availability of a better tolerated antidopaminergic medication such as aripiprazole has led to a change in prescribing preferences of the European experts: risperidone was rated as first choice in the 2011 survey, but lost its pole position to aripiprazole in the 2022 update [24,29].