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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
Weight gain occurs with most typical antipsychotics, in up to 40% of cases, and with olanzapine and clozapine particularly commonly. Data on risperidone and sertindole indicate an average gain in weight of 1-4 kg over the first 6-8 weeks of treatment.194 Weight gain usually plateaus during the first year of treatment and should be managed by dietary control (preferably initiated early on in treatment). There are some claims that amisulpride and ziprasidone may be less likely to produce weight gain.
Questions and Answers
Published in David Browne, Brenda Wright, Guy Molyneux, Mohamed Ahmed, Ijaz Hussain, Bangaru Raju, Michael Reilly, MRCPsych Paper I One-Best-Item MCQs, 2017
David Browne, Brenda Wright, Guy Molyneux, Mohamed Ahmed, Ijaz Hussain, Bangaru Raju, Michael Reilly
Answer: A. Sertindole may cause less weight gain than other antipsychotics and has low incidence of EPSE but some concerns remain regarding QTc prolongation (as with other antipsychotics). It produces blockade of a number of receptors: D2, D3, 5HT2A, 5HT2c, 5HT6, 5HT7 and α1 adrenergic receptors. [Z. pp. 84–5]
Acne Antibiotics
Published in Sarah H. Wakelin, Howard I. Maibach, Clive B. Archer, Handbook of Systemic Drug Treatment in Dermatology, 2015
Alexander Nast, Ricardo N. Werner
Erythromycin has numerous drug interactions due to its inhibitory effects on the cytochrome p450 (CYP450) 3A isoenzyme, and the cardiotoxicity of certain drugs may also be increased. It should not be prescribed with the following: Antipsychotic drugs including droperidol, pimozide, sertindole.Cisapride (discontinued in the UK and USA), due to the risk of ventricular arrhythmias.Ergot alkaloids (unlicensed use for headache), due to increased risk of ergotism.Mizolastine, due to QT prolongation.Simvastatin, lovastatin, due to increased risk of myopathy.
Efficacy, safety, and tolerability of ulotaront (SEP-363856, a trace amine-associated receptor 1 agonist) for the treatment of schizophrenia and other mental disorders: a systematic review of preclinical and clinical trials
Published in Expert Opinion on Investigational Drugs, 2023
Gia Han Le, Emily S. Gillissie, Taeho Greg Rhee, Bing Cao, Yazen Alnefeesi, Ziji Guo, Joshua D. Di Vincenzo, Muhammad Youshay Jawad, Andrew M. March, Ranuk Ramachandra, Leanna M.W. Lui, Roger S. McIntyre
To overcome the limitations of typical antipsychotic drugs, second generation/atypical antipsychotic drugs were developed. In a double-blind study examining clozapine’s effectiveness for treatment-resistant schizophrenia, 30% of clozapine-treated patients experienced significantly greater improvements to positive and negative symptom scores. In contrast, only 4% of chlorpromazine-treated patients experienced these improvements [18]. Despite some degree of effectiveness, results from a meta-analysis comparing first- and second-generation antipsychotics indicate that only some of the studied second-generation antipsychotics displayed improved overall efficacy compared to first-generation antipsychotics, including amisulpride, clozapine, olanzapine, and risperidone [19]. First-generation drugs that yielded higher efficacy than second-generation drugs for the treatment of both positive and negative symptoms of schizophrenia include aripiprazole, quetiapine, sertindole, ziprasidone, and zotepine [19]. Case studies also suggest cariprazine – a third-generation antipsychotic – and brexpiprazole to be candidate atypical antipsychotics to reduce both the positive and negative symptoms of schizophrenia; however, further research with larger sample sizes is required to examine the long-term effects of these agents as the results from these clinical cases are not generalizable [20,21].
Pharmacogenetics of tardive dyskinesia in schizophrenia: The role of CHRM1 and CHRM2 muscarinic receptors
Published in The World Journal of Biological Psychiatry, 2020
Anastasiia S. Boiko, Svetlana A. Ivanova, Ivan V. Pozhidaev, Maxim B. Freidin, Diana Z. Osmanova, Olga Yu Fedorenko, Arkadyi V. Semke, Nikolay A. Bokhan, Bob Wilffert, Anton J. M. Loonen
A total of 194 patients received typical antipsychotics (of which haloperidol was the most often used: 115 patients; chlorpromazine, 44 patients (as well as chlorprothixene, zuclopenthixol, thioridazine and periciazine)). A total of 172 patients received atypical antipsychotics (mainly risperidone, clozapine and quetiapine, and to a lesser extent olanzapine, sertindole, paliperidone, and amisulpride), and 83 patients received combined therapy. Patients were assessed once for the presence or absence of dyskinesia according to the abnormal involuntary movement scale (AIMS) (Loonen and Van Praag 2007; Loonen et al. 2000, 2001). The AIMS scores were transformed into a binary form (presence or absence of dyskinesia) with Schooler and Kane's criteria (1982). Schooler–Kane criteria require: (i) at least 3 months of cumulative exposure to neuroleptics; (ii) the absence of other conditions that might cause involuntary movements and (iii) at least moderate dyskinetic movements in one body area (≥3 on AIMS) or mild dyskinetic movements in two body areas (≥2 on AIMS).
New discoveries for an old drug: a review of recent olanzapine research
Published in Postgraduate Medicine, 2020
Amir M Meftah, Elizabeth Deckler, Leslie Citrome, Joshua T Kantrowitz
In a recent meta-analysis [17], the comparative short-term tolerability of 32 antipsychotic drugs used to treat schizophrenia were compared. As expected, olanzapine, along with zotepine and sertindole, produced significantly more weight gain than most other drugs. The mean weight gain with olanzapine use was 2.78 kg over six weeks. The relative risk hierarchy for patients with at least 7% weight gain was similar, with olanzapine having the highest rates. Similarly, in a meta-analysis of long-term treatment, olanzapine was found to cause more weight gain than all other second-generation antipsychotics except clozapine [20]. A recent meta-analysis [45] suggests that olanzapine-induced weight gain may be dose related.