bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metabolic syndrome in schizophrenia -impact of antipsychotic medication
Authors: Maria-Silvia T.M.-S. 
Published: May 2011

Metabolic syndrome generally includes some or all of the following: elevated blood pressure, abdominal obesity, diabetes or “prediabetes” (impaired glucose tolerance, impaired fasting glucose or insulin resistance), dyslipidemia (high levels of triglycerides and/or HDL), and inflammatory markersP.S. a 34 year old, diagnosed with Paranoid schizophrenia. The patient comes from a disorganised family. The disease started at 18 years with psychotic symptoms - delirious, psychotic behavior, aggression, neglect of personal hygiene. He received almost continuous antipsychotic medication. In recent years received the second generation antipsychotic medication. Under this medication increased weight reaching 160 kg in weight. The most significant weight gain occurred in recent years under neuroleptic medication with clozapinum. Hypertension (max 200/120) appeared as a complication of increased weight, requiring antihypertensive medication. Has not other endocrine problems. Laboratory values increased cholesterol, triglyceride, and lipid. Glycemia remained normal. In the last six months patient received amisulpiridum 800 mg/day. In same conditions of life the patient has lost 40 kg in weight reaching 140 kg. Family history- mother obesity and HTA;Weight and (BMI) initially 160kg/180 cm then 120 kg/180 cm;Waist circumference 140 cm;Blood pressure initially 200/120 mm Hg then160 /110 mmhg;Fasting lipids increased,glucose normal Conclusion: Assessment of risk factors is necessary before prescription of antipsychotics. Especially weight, BMI, family history for obesity, and ethnicity should be evaluated. People taking antipsychotics that increase the risk of MetS should be educated on this subject. They should be advised about their diet and lifestyle, about how to recognize symptoms of MetS and its consequences.
The neuroprotective potentially of agomelatine - animal model study
Authors: Marinescu D. , Mogoanta L. , Udristoiu T. , Udristoiu I. , Pirici D. 
Published: May 2011

BackgroundMajor depressive disorder associated the increase of cortisol level and high level of cortisolemia is correlated with the decrease of neuroprotection. Hippocampus low volume is a marker for depressive disorder. The cognitive impairment in depression is linked with hippocampus - enthorinal structures-frontal cortex disconectivity. Melatoninic agonists can increase the neuroprotection and improve depressive mood.MethodsWe formed 2 study lots each constitued of 5 male adults rats (200–250 g), held through the study duration in temperature, humidity, food and ambient stress less conditions, compared to a control lot. The studied substances were administrated intraperitoneal, daily, for 10 days, saline solution equivalent to dexametasone (0.20 mg/kg/day) (N1); 14 days we administered 10 mg/kg/daily of agomelatine through a stomach tube and the following 10 days of dexametasone and agomelatine in the same dosage (N2). The N1 lot was sacrificed in the day 11, and the N2 lot was sacrificed in the day 25.The sample brain was histopathologically processed: formalin (10%) and ethyl alcohol (96%) fixation and paraffine embeded. Microtome slices were stained in hematoxyline-eosine, trichromicGS, PAS-hematoxyline, toluidine blue and methylen blue for Nissle corpuscles. The obtained slices were studied with optical microscopy, the target of our study was hippocampus and frontal cortex.ResultsThe hippocampus and frontal cortex presents important histopathological abnormalities (neuronal death, vacuolisation, axonal fragmentation) for N1 after dexametasone. These changes are decreased in N2.ConclusionsAgomelatine on the animal model actioned with a neuroprotective effect in the hippocampus and frontal cortex front of cortisolic aggresion (marker for depression).
An increase in bone stability in an aripiprazole add-on or switching study
Authors: Masand S. , Sherwood R. , Aitchison K.J. 
Published: May 2011

IntroductionSchizophrenia is a mental health disorder associated with high rates of osteoporosis. Studies have suggested antipsychotics as a major cause of accelerated decrease in bone mineral density.Oestrogen deficiency contributes to osteoporosis and causes increased osteoclast numbers/osteoclastic activity. Prolactin suppresses hypothalamo-pituitary-ovarian axis activity, leading to decreased oestrogen concentrations.Aripiprazole, an ‘atypical’ antipsychotic, is a partial agonist at dopamine D2-receptors, while other atypical antipsychotics are antagonists at these receptors. Dopamine inhibits prolactin release via these receptors at the anterior pituitary. Aripiprazole has been found to decrease prolactin concentrations in chronic schizophrenics and may be protective against osteoporosis.Quantitation of specific markers of osteoclastic (cross-linked N-telopeptide (NTX)) and osteoblastic activity (bone alkaline phosphatase (BAP)) can be correlated with bone resorption and bone formation, respectively.ObjectivesExploring whether aripiprazole is effective in stabilising bone turnover.AimsInvestigate changes in urinary markers of bone turnover.MethodsWe performed 52 week, open-label, intention-to-treat study, offering either a switch to aripiprazole or aripiprazole as add-on to initial antipsychotic medication.Serial measurements of prolactin, testosterone, 17-β-oestradiol, serum BAP, albumin, urinary creatinine, and urinary NTX concentrations were taken between 0 and 52 weeks.ResultsAt the end-point of study, versus the baseline, there were significant decreases in concentrations of urinary markers of bone resorption (P = 0.002 for NTX) and bone formation (P = .026 for BAP). Additionally, a significant decrease in prolactin (P = 0.004) and significant increase in 17-β-oestradiol concentrations (P = 0.015) were found.ConclusionsOur results show decreased overall bone turnover; and increased long-term bone stability in patients who changed medication.
Glutamate theory of depression-new elements
Authors: Mititelu A.G. 
Published: May 2011

IntroductionIt is well known that actual mechanisms which explain depression are very exhaustive and at same time extremely limited. Among these ones, it had been given the priority, maybe too quick, to serotonin hypothesis. Even so, the actual SSRI and SRNI classes doesn’t do. really, a lot in alleviating the course of the disease. Recent randomised clinical trials and clinic -epidemiological studies support the idea that something more effective must be offered. On the other side addiction reveals more and more in depth correlations with all major psychiatric disorders.ObjectivesIt is possible to develop in the close future new chemical products which could act in more effective way for the reduction or even cancelling of the symptoms determined by the alteration of major neurotransmitters-, GABA and glutamate.AimsBased on huge interconnection which exists between depression and drug dependence at various levels-especially through the effects exerted by particular anti depressant and some of anti craving medications, it is possible to evaluate the impact which some new pharmaceutical compounds -derivated from glutamate type of receptor NMDA-might exert upon various types of depression elicited by patients with associated drug dependence.MethodsHad been realised a thematical reanalysis of the studies published on Medline, EMBASE and OVID about this subject.ResultsThe conclusion of the studies reveals the huge potential represented by treatment with some types of NMDA antagonists-Ketamine. The putative site of action is prefrontal cortex and is had been proved highly efficient in MDD patients.
Sleep-memory-plasticity:A circuit closed by Gaba?
Authors: Mititelu A. 
Published: May 2011

It is already widely known that benzodiazepines, the most prolific compound for pharma industry, are the most used psychotropic medication used at moment. It is striking that even now, after more than 50 yrs from first use of Diazepam, still exerts such a massive interest. Both mechanism, of dependence and withdrawn are not still unknown. Benzodiazepines by their structure and sites of action upon GABA receptors realise a huge effect in majority of neuronal circuits.ObjectivesThe effect of BDZ in mood and affective disorders and also in major psychotic sdr-Schizophrenia realise an reduction of hyper GABA influence. acting on specific neuronal populations which posses particularly alpha 5 GABAa receptors they produce sedative but non anxiolytic effect. Also is still an “mistery” how only retrograde amnesia is produced and why plasticiticity occurs after a longtime use of BDZ facilitating the development of tolerance.AimsBy a better intimate description of mechanisms by which GABAa receptors realise the sedative action and development of less side effects comparing with actual BDZ in use, even from different classes.MethodsIn this communication we had realised a thematical analysis of all studies (randomised clinical trials, clinical case study) but also various experimental research with this subjects-sleep, memory, plasticity. All had been indexed in PubMed, EMBASE, www.ionchannels.com and Science Direct.ResultsThe conclusion of our tematical study and also, our previous research suggests antagonists of GABA a or agonists of beta carbolines could be proven solid point of start for more efficient therapeutic substances.
Collaborative study of compliance in psychotic patients with risperidone long-acting injection (RLAI) in the last 5 years
Authors: Molina Ramos R. , Arnillas H. , Playà J. , Sánchez de Muniain M. , LLiteras M. , Hernandez B. 
Published: May 2011

IntroductionCompliance is essential to achieve the best results in serious mental illness like schizophrenia.ObjectivesIt was expected that the use of second-generation oral antipsychotics with less extrapyramidal side effect profile would improve the compliance, but the results do not support these expectations except in the case of risperidone long-acting injection.AimsThe aim of this study is to assess the degree of compliance in outpatients who were started treatment with RLAI while they were hospitalized for an acute psychotic episode in psychiatric unit.MethodsA retrospective study was conducted by reviewing medical records of hospitalized patients for psychotic episodes over the past 5 years in three hospitals in Mallorca (Balearic Islands, Spain) -Hospital de Manacor, Hospital son Llatzer and Hospital de Inca). Due to computerization of medical records, we knew the degree of compliance with treatment and outcome in outpatient clinics. We designed a case report data (CRD) to assess specific variables in our study that was completed for each patient.ResultsThe mean duration of treatment in patients who continue with RLAI was 38.8 months. Overall. 69.5% continued with the treatment after 5 years. The patients who continued treatment were rehospitalazed 20% less than the ones who discontinued.ConclusionsThe compliance with RLAI in outpatients was high even in patients with substances abuse. The patients who remain on treatment from hospital discharge have less readmissions. The most common dosis of RLAI is 50 mg. Lack of insight was the most frequent cause of discontinuation.
Managing strategies for antidepressant-related sexual dysfunction. results from a multicentric, pragmatic study with 2000 patients in spain: the SALSEX-I study
Authors: Montejo A.L. , Majadas S. , Calama J. , Hernandez A.I. ,   SALSEX-I Project Working Group
Published: May 2011

IntroductionAntidepressant-related sexual dysfunction (ADr-SD) is the most frequent and long-lasting adverse event, often underestimated and rarely spontaneously communicated. Strategies to manage it haven’t been explored to date.Study aimTo explore ADr-SD clinical management in regular practice.Objectives1.To stablish the prevalence of SD in patients following antidepressant treatment.2.To describe the therapeutic interventions used when SD is detected.MethodsCross-sectional, multicentric and naturalistic study. Patients taking antidepressant for at least two months without previous SD were included. SD was evaluated with the specific questionnaire PR-Sex-DQ (SALSEX, Montejo et al 2001).Results1988 out of 2000 patients recruited resulted eligible for the analysis. According to PRSexDQ scores SD was present in 87.5% ot the sample. Only 44.2% communicated it spontaneusly. 66.2% reported regular to poor tolerance of SD and 19.6% had thought about discontinuing treatment due to it. Regarding the therapeutic interventions used for managing ADr-SD, waiting for its spontaneus remission was the most frequent strategy reported (36.8%), followed by changing the antidepressant (32.5%) and reducing the dosage (18.5%); 5% chosed “weekend holidays”, 4% discontinued the antidepressant, 2.5% associated another antidepressant and 1.3% added a 5-phosphodiesterase inhibitor. Bupropion and mirtazapine were the antidepressants most frequently selected for the switching and association strategies.ConclusionsThese results study highlight the high rates of SD related to antidepressants and its potential association with non-adherence to treatment. Despite this unfortunatelly clinicians do prefer to wait rather than performing any active strategy to manage this adverse event.
Antipsychotic polytherapy versus antipsychotic monotherapy in patients with schizophrenia and other psychoses
Authors: Morales Alcaide N. 
Published: May 2011

IntroductionAntipsychotic therapy is the cornerstone of the treatment of psychotic disorders. Although clinical guidelines recommend the use of antipsychotics in monotherapy, the combination of two or more antipsychotics is a common habit in clinical practice, especially in cases resistant to treatment with one antipsychotic, although there are few controlled trials that support this treatment modality.ObjectivesTo analyze the characteristics of antipsychotic therapy in patients admitted to hospitalization with diagnoses of schizophrenia and other psychoses, to determine if there are differences between diagnostic groups.MaterialWe analyzed a sample of 241 patients admitted during 2009, 97 women and 144 men, with schizophrenia and other psychoses.MethodsWe designed a protocol of collecting data based on clinical histories of patients, reflecting the gender, age, diagnosis and treatment regimen (monotherapy or combination therapy), and performed a statistical analysis using SPSS.ResultsOf the sample, 40.2% were females and 59.8% were males. The mean age was 39.7 years old.The diagnosis of schizophrenia was obtained in 60.2% of patients, while the remaining 39.8% were diagnosed with other psychoses (schizoaffective disorder, chronic delusional disorder, schizophreniform disorder, brief psychotic disorder, psychotic disorder not otherwise specified and other.)The combination therapy was used in 62.2% of patients, while the remaining 37.8% were treated with monotherapy.ConclusionsCombination therapy is used more often in male patients and in patients diagnosed with schizophrenia, while monotherapy is used more in women and patients with other psychoses.
Comparative efficacy, effectiveness and harms of second-generation antidepressants in the pharmacologic treatment of adult depression
Authors: Morgan L. , Gartlehner G. 
Published: May 2011

IntroductionSecond-generation antidepressants dominate the medical management of major depressive disorder (MDD). Two published comparative effectiveness reviews (CER) provide conflicting evidence about the comparative efficacy and safety of second-generation antidepressants for treating MDD.ObjectivesTo compare the benefits and harms of bupropion, citalopram, desvenlafaxine, duloxetine, escitalopram, fluoxetine, fluvoxamine, mirtazapine, nefazodone, paroxetine, sertraline, trazodone, and venlafaxine for the treatment of MDD in adults.MethodsWe updated a CER published in 2007 by the Agency for Healthcare Research and Quality searching MEDLINE, Embase, The Cochrane Library, and the International Pharmaceutical Abstracts up to May 2010. Two persons independently reviewed the literature, abstracted data, and rated the risk of bias. If data were sufficient, we conducted meta-analyses of head-to-head trials of the relative benefit of response to treatment. In addition, we conducted mixed treatment comparisons to derive indirect estimates of the comparative efficacy among all second-generation antidepressants.ResultsOverall, no substantial differences in efficacy could be detected among second-generation antidepressants. Statistically significant differences in response rates between some compared drugs are small and likely not clinically relevant. Differences exist in the incidence of specific adverse events and the onset of action. Venlafaxine leads to higher rates of nausea and vomiting, sertraline to higher rates of diarrhea, and mirtazapine to higher rates of weight gain than comparator drugs. Bupropion caused lower rates of sexual dysfunction than other antidepressants.ConclusionsOur findings indicate that the existing evidence does not warrant the choice of one second-generation antidepressant over another based on greater efficacy and effectiveness.
Effects of antipsychotics on cognitive functions: an ERP study in healthy controls
Authors: Mucci A. , Galderisi S. , Vignapiano A. , Russo D. , Romano P. , Plescia G. , Maj M. 
Published: May 2011

IntroductionClinical studies on cognitive effects of second generation antipsychotics produced disappointing findings probably due to the heterogeneity of the clinical populations under investigation, as well as to poor sensitivity of neurocognitive indices. Event-Related Potentials (ERPs) provide a functional measure of electrical brain activity time-locked to discrete stages of information processing. They have been widely used as putative biological markers of cognitive abnormalities in schizophrenia and represent useful indices in the investigation of the cognitive effects of psychotropic drugs.ObjectivesThe present study investigated the effect of risperidone, haloperidol and placebo on N1 and P3 in male healthy subjects.MethodsERPs were recorded during a three-tone oddball task in which target, standard and rare-nontarget tones were randomly presented. Subjects had to press a button when hearing a target tone. Amplitude and topography of the ERP component maps at peak latencies were compared across conditions. If a significant drug effect was obtained, changes in the cortical sources of the corresponding ERP component were analyzed using Low-Resolution Electromagnetic Tomography (LORETA).ResultsThe amplitude of N1 for attended stimuli and of P3 for rare-nontargets (P3a) was significantly increased only by risperidone. No significant change was observed in overall topographic features and in LORETA cortical sources of the same components. No significant drug effect was demonstrated for the latency of all the investigated components and for P3b amplitude.ConclusionsOur findings suggest that risperidone has a favorable effect on early attention processes and automatic attention allocation.
Does prescribing depot medication really improve medication adherence?
Authors: Nendick J. , Tacchi M.-J. , Scott J. 
Published: May 2011

IntroductionClinicians often prescribe depot medication assuming that it will improve medication adherence. Few studies have systematically explored patterns of non-adherence with depots or whether the beliefs and attitudes that influence adherence are similar to those that affect acceptability and adherence of oral medication.ObjectivesTo investigate adherence with and attitudes towards depot medication.Aims(1)To explore non-adherence with depot medication.(2)To examine key determinants of acceptability of depot versus oral treatment.MethodsPatients with a severe mental disorder receiving depot medication completed a face to face interview incorporating several ratings, including the Beliefs about Medication Questionnaire (BMQ). Frequency of depot injections and adherence rates were recorded over two years. Data were compared with that from similar patients receiving oral medication.ResultsFull adherence with depots was only slightly higher than with oral medication (77% v 71%). Although side effect ratings were correlated with the BMQ-Concerns sub-scale (r.29) the most robust single predictor of adherence was a high score on the BMQ Necessity scale (r .46). In both oral and depot medication groups the combination of Low Necessity and High Concerns predicted poor adherence (Odds Ratio 4.21).ConclusionsDepot medication is a necessary but not sufficient treatment for many non-adherent patients. Our findings suggest that barriers to acceptance of depots vary little from those that impair adherence with oral antipsychotics and that interventions to modify these beliefs are as important as the mode of delivery of treatment.
Pleural effusion as a complication of clozapine treatment
Authors: Hospers A. , Arends J. , Timmerman L. , Oven W.V. 
Published: May 2011

IntroductionClozapine treatment has been recognized as a superior treatment in schizophrenia. Clozapine treatment has also be accompanied with several rare but severe adverse events, like neutropenia, agranulocytosis, myocarditis, pericarditis and polyperositis. We report a patient that suffers from hyperleucocytemia, eosinophilia and pleuritis, due to clozapine treatment, the adverse events disappeared after a switch to aripiprazole.ObjectivesTo review the literature on reports on pleuritis and polyserositis in order searching for guidance in these clinical situation, like the need tot interrupt the medication, the prognosis and if rechallenges are reported. Another objective was to discover if something is known about the underlying mechanism.MethodsTo review the literature, we used the following terms: clozapine, treatment, immunological reaction, neutropenia, leucopenia, epicarditis, polyserositis, pleuritis, pleural effusion, underlying mechanisms, risk factors.A literature search was performed in Pubmed® and Embase Psychiatry® in the period longing from 1972 till October 2010ResultsRisk factors as well as the underlying mechanisms offer no guidance for dealing with the clinical critical situations.There are only a few reports on pleural effusion, there are some reports on pleural effusion in combination with epicarditis, there are some reports on polyserositis including pleural effusion.No rechallenges are reported of clozapine on pleural effusion.There is no information in the literature on the risk that a pleuritis will extend to other organs, like the heart and the liver, when continuing the clozapine treatment.ConclusionHypotheses about the underlying mechanism will be presented. A program of additional diagnostics will be described