MyMedR

Fulltext Peripheral PDLIM5 expression in bipolar disorder and the effect of olanzapine administration

Zain MA, Jahan SN, Reynolds GP, Zainal NZ, Kanagasundram S, Mohamed Z

BMC Med Genet, 2012;13:91.

PMID: 23031404 DOI: 10.1186/1471-2350-13-91

One of the genes suggested to play an important role in the pathophysiology of bipolar disorder (BPD) is PDLIM5, which encodes LIM domain protein. Our main objective was to examine the effect of olanzapine treatment on PDLIM5 mRNA expression in the peripheral blood leukocytes of BPD patients.

Matched MeSH terms: Antipsychotic Agents/therapeutic use*

Fulltext Validation of the Malay version of auditory verbal learning test (MVAVLT) among schizophrenia patients in Hospital Universiti Sains Malaysia (HUSM), Malaysia

Zahiruddin Othman, Muhammad Najib Muhammad Alwi, Kamarul Imran Musa, Muhammad Najib Muhammad Alwi, Ruzita Jamaluddin

ASEAN Journal of Psychiatry, 2009;10(1):54-74.

MyJurnal

Objective: Many studies have emphasized the significance of verbal memory for the functional outcome in schizophrenia. A preserved capability to encode and recall verbal information is essential for the long-term efficacy of psychoeducational programs and other
psychological intervention to ensure the successful transfer of newly acquired skills or knowledge into everyday life. Aims of this study aimed to validate the MVALT among schizophrenia patients in HUSM. Methods: The subjects were 15 schizophrenia patients
conveniently selected from the patients that attended follow up at the psychiatry clinic in HUSM or inpatients who have been admitted during the study period and 15 healthy control subjects as a comparison. Reliability and validity of the MVAVLT were analyzed. Results: The validation study showed that the Malay version Auditory Verbal Learning Test (MVAVLT) had a good validity (factor analysis 0.66 to 0.98) and test-retest reliability (pearson correlation ranged from 0.24 to 0.84) and has been shown to be sensitive in
discriminating between normal and schizophrenia patients. In line with the previous research, the schizophrenia patients performed significantly worse than healthy control in all indexes measured in MVAVLT. Conclusion: The screening of deficits in verbal learning
and memory among the schizophrenia patients is important, for early detection and treatment since it can be helpful for clinicians and psychologists in their counseling sessions. Subsequently, it helps patients to reduce such cognitive difficulties and their impact by using specific rehabilitation with the usage of newer antipsychotic agents.

Matched MeSH terms: Antipsychotic Agents

Fulltext Psychosis induced by cefuroxime and metronidazole

Zahiruddin O, Shanooha M, Mohd Azhar MY

Med J Malaysia, 2014 Feb;69(1):33-4.

PMID: 24814627 MyJurnal

We report a case 35-year-old lady who developed acute psychosis following administration of cefuroxime and metronidazole. Earliest mood changes occurred on the second day of antibiotics therapy. She developed hallucinations, delusions and bizarre behavior 1 day after the completion of the antibiotic therapy. All the relevant investigations including CT brain were normal. The psychosis resolved completely within 5 days of antipsychotic treatment.

Matched MeSH terms: Antipsychotic Agents

Influence of DRD2 polymorphisms on the clinical outcomes of patients with schizophrenia

Zahari Z, Teh LK, Ismail R, Razali SM

Psychiatr Genet, 2011 Aug;21(4):183-9.

PMID: 21206399 DOI: 10.1097/YPG.0b013e3283437250

Variations in the gene for dopamine D2 receptor (DRD2) might have an influence on the outcome of antipsychotic treatment in schizophrenia. The objective of this study was to investigate the influence of DRD2 polymorphisms on treatment outcomes in patients with schizophrenia.

Matched MeSH terms: Antipsychotic Agents/therapeutic use

Weight gain and first-generation antipsychotics: experience from a developing country

Yoon CK

J Clin Psychopharmacol, 2008 Oct;28(5):574-6.

PMID: 18794660 DOI: 10.1097/JCP.0b013e3181855cbc

Matched MeSH terms: Antipsychotic Agents/adverse effects*; Antipsychotic Agents/therapeutic use

Fulltext Branch retinal vein occlusion associated with quetiapine fumarate

Yong KC, Kah TA, Ghee YT, Siang LC, Bastion ML

BMC Ophthalmol, 2011;11:24.

PMID: 21867521 DOI: 10.1186/1471-2415-11-24

To report a case of branch retinal vein occlusion in a young adult with bipolar mood disorder treated with quetiapine fumarate.

Matched MeSH terms: Antipsychotic Agents/adverse effects*; Antipsychotic Agents/therapeutic use

Brexpiprazole for the treatment of schizophrenia

Yee A

Expert Rev Neurother, 2016;16(2):109-22.

PMID: 26650624 DOI: 10.1586/14737175.2016.1129901

Brexpiprazole (OPC-34712) is a novel serotonin-dopamine activity modulator, which has recently been approved by the U.S Food and Drug Administration for the treatment of schizophrenia. The aim of this paper is to systematically synthesize all data of the efficacy, safety and tolerability of Brexpiprazole in treating schizophrenia. The terms 'Brexpiprazole', 'OPC-34712' and 'schizophrenia' were searched. A total of 12 clinical trials with 7 available data records were found. The pooled effect size of Brexpiprazole 1 mg, 2 mg and 4 mg were all superior to placebo in terms of the change from baseline in positive and negative syndrome scale (PANSS) total score at week 6 (weighted mean difference = -3.74, p = 0.044; weighted mean difference = -5.76, p

Matched MeSH terms: Antipsychotic Agents/therapeutic use

Fulltext The effect of nicotine dependence on psychopathology in patients with schizophrenia

Yee A, Bt Nek Mohamed NN, Binti Hashim AH, Loh HS, Harbajan Singh MK, Ng CG, et al.

Biomed Res Int, 2015;2015:730291.

PMID: 26060820 DOI: 10.1155/2015/730291

INTRODUCTION: Our study aims to determine the prevalence of nicotine dependence and investigate the effect of nicotine dependence on psychopathology among schizophrenia patients.
METHODS: A cross-sectional study was carried out in an outpatient psychiatric clinic at a general hospital in Malaysia. 180 recruited subjects were administered the Malay version of Mini International Neuropsychiatric Interview (MINI), the Positive and Negative Symptom Scale (PANSS), and the Malay version of Fagerstrom Test for Nicotine Dependence (FTND-M) questionnaires.
RESULTS: The prevalence of nicotine dependence among the subjects was 38.1% (n = 69) and they were mainly composed of male gender, Malay ethnicity, being treated with atypical antipsychotics, and taking other illicit drugs or alcohol. Subjects with severe nicotine dependence scored less in the negative subscale of PANSS compared with the nonsmokers (P = 0.011). On performing the hierarchy multiple regressions, dependence status still significantly predicted negative scores after adjusting the confounders (t = -2.87, P = 0.005).
CONCLUSION: The rate of nicotine use disorder among schizophrenia patients in this study is higher than that of the general population in Malaysia. The significant association between nicotine dependence and negative psychopathology symptoms will help the healthcare practitioners in their management of nicotine dependence among schizophrenia patients.

Study site: outpatient psychiatric clinic in a general hospital

Matched MeSH terms: Antipsychotic Agents/administration & dosage*

Fulltext Polypharmacy and psychotropic drug loading in patients with schizophrenia in Asian countries: Fourth survey of Research on Asian Prescription Patterns on antipsychotics

Yang SY, Chen LY, Najoan E, Kallivayalil RA, Viboonma K, Jamaluddin R, et al.

Psychiatry Clin Neurosci, 2018 Aug;72(8):572-579.

PMID: 29761577 DOI: 10.1111/pcn.12676

AIM: The aim of the present study was to survey the prevalence of antipsychotic polypharmacy and combined medication use across 15 Asian countries and areas in 2016.

METHODS: By using the results from the fourth survey of Research on Asian Prescription Patterns on antipsychotics, the rates of polypharmacy and combined medication use in each country were analyzed. Daily medications prescribed for the treatment of inpatients or outpatients with schizophrenia, including antipsychotics, mood stabilizers, anxiolytics, hypnotics, and antiparkinson agents, were collected. Fifteen countries from Asia participated in this study.

RESULTS: A total of 3744 patients' prescription forms were examined. The prescription patterns differed across these Asian countries, with the highest rate of polypharmacy noted in Vietnam (59.1%) and the lowest in Myanmar (22.0%). Furthermore, the combined use of other medications, expressed as highest and lowest rate, respectively, was as follows: mood stabilizers, China (35.0%) and Bangladesh (1.0%); antidepressants, South Korea (36.6%) and Bangladesh (0%); anxiolytics, Pakistan (55.7%) and Myanmar (8.5%); hypnotics, Japan (61.1%) and, equally, Myanmar (0%) and Sri Lanka (0%); and antiparkinson agents, Bangladesh (87.9%) and Vietnam (10.9%). The average psychotropic drug loading of all patients was 2.01 ± 1.64, with the highest and lowest loadings noted in Japan (4.13 ± 3.13) and Indonesia (1.16 ± 0.68), respectively.

CONCLUSION: Differences in psychiatrist training as well as the civil culture and health insurance system of each country may have contributed to the differences in these rates. The concept of drug loading can be applied to other medical fields.

Matched MeSH terms: Antipsychotic Agents

Prescribing patterns of low doses of antipsychotic medications in older Asian patients with schizophrenia, 2001-2009

Xiang YT, Dickerson F, Kreyenbuhl J, Ungvari GS, Wang CY, Si TM, et al.

Int Psychogeriatr, 2012 Jun;24(6):1002-8.

PMID: 22300452 DOI: 10.1017/S1041610211002791

This study examined the use of low doses of antipsychotic medications (300 mg/day CPZeq or less) in older Asian patients with schizophrenia and its demographic and clinical correlates.

Matched MeSH terms: Antipsychotic Agents/administration & dosage; Antipsychotic Agents/therapeutic use*

Antipsychotic treatment in older schizophrenia patients with extrapyramidal side effects in Asia (2001 - 2009)

Xiang YT, Kreyenbuhl J, Dickerson FB, Ungvari GS, Wang CY, Si TM, et al.

Int J Clin Pharmacol Ther, 2012 Jul;50(7):500-4.

PMID: 22541750 DOI: 10.5414/CP201683

This study surveyed the prescribing patterns of antipsychotic medications in Asian older schizophrenia patients with extrapyramidal side effects (EPS) during the period between 2001 and 2009.

Matched MeSH terms: Antipsychotic Agents/adverse effects*

Use of electroconvulsive therapy for Asian patients with schizophrenia (2001-2009): Trends and correlates

Xiang YT, Ungvari GS, Correll CU, Chiu HF, Lai KY, Wang CY, et al.

Psychiatry Clin Neurosci, 2015 Aug;69(8):489-96.

PMID: 25708964 DOI: 10.1111/pcn.12283

Little is known about electroconvulsive therapy (ECT) use in Asian inpatients with schizophrenia. This study examined trends of ECT use for schizophrenia patients in Asia between 2001 and 2009 and its independent demographic and clinical correlates.

Matched MeSH terms: Antipsychotic Agents/therapeutic use

Cost analysis of risperidone long-acting injection in the treatment of schizophrenia and schizoaffective disorders in Hong Kong: an approach using generalised estimating equations

Wu DB, Lee EH, Chung WS, Chow DP, Lee VW, Wong MC, et al.

Psychiatry Res, 2013 Dec 30;210(3):745-50.

PMID: 24012164 DOI: 10.1016/j.psychres.2013.07.012

Schizophrenia is one of the most expensive psychiatric illnesses. This study compared retrospectively health-care resources consumed 12 months before and 24 months after risperidone long-acting injection (RLAI) treatment in Hong Kong. A mirror-image analysis was conducted using data (N=191) from three public hospitals in Hong Kong from 2003 to 2007. The main outcome measure was hospitalisation cost. Other secondary outcomes such as hospitalisation episodes, outpatient visits and adverse events were also compared. A predictive model was established using linear regression based on generalised estimating equations. Analysis showed that RLAI was associated with a reduction in hospitalisation cost by HK$10,001,390 (24.7%) (HK$40,418,694 vs. HK$30,417,303; P-value <0.05). Days of hospitalisation were reduced by 1538 days (10.1%) (15,271 vs. 13,733; P-value <0.05). The predictive model estimated that the hospitalisation cost of patients using RLAI was only 11.1% (3.1-3.93%, 95% confidence interval (CI)) compared to those receiving conventional antipsychotics combined with oral risperidone. Cost of hospitalisation was significantly reduced after RLAI therapy. However, results should be considered as indicative or suggestive only, due to potential channelling bias where certain drug regimens are preferentially prescribed to patients with particular conditions. The findings from our study may be useful in health-care decision making considering treatment options for schizophrenia in resource-limited settings.

Matched MeSH terms: Antipsychotic Agents/administration & dosage*; Antipsychotic Agents/economics; Antipsychotic Agents/therapeutic use

Olanzapine-induced and Risperidone-induced Leukopenia: A Case of Synergistic Adverse Reaction?

Woon LS, Tee CK, Gan LLY, Deang KT, Chan LF

J Psychiatr Pract, 2018 Mar;24(2):121-124.

PMID: 29509183 DOI: 10.1097/PRA.0000000000000292

Leukopenia is a known hematological side effect of atypical antipsychotics. We report a case of an antipsychotic-naive patient with schizophrenia who developed leukopenia after a single dose of olanzapine, which worsened during subsequent treatment with risperidone. Normalization of the white blood cell counts occurred within 24 hours of risperidone discontinuation. Possible synergistic mechanisms underlying olanzapine-induced and risperidone-induced leukopenia are discussed. This case highlights the challenges in identifying and managing nonclozapine antipsychotic-induced leukopenia in a susceptible patient.

Matched MeSH terms: Antipsychotic Agents/administration & dosage; Antipsychotic Agents/adverse effects*

The Medication Risk of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Asians: The Major Drug Causality and Comparison With the US FDA Label

Wang YH, Chen CB, Tassaneeyakul W, Saito Y, Aihara M, Choon SE, et al.

Clin. Pharmacol. Ther., 2019 01;105(1):112-120.

PMID: 29569740 DOI: 10.1002/cpt.1071

Specific ethnic genetic backgrounds are associated with the risk of Stevens-Johnson syndrome / toxic epidermal necrolysis (SJS/TEN) especially in Asians. However, there have been no large cohort, multiple-country epidemiological studies of medication risk related to SJS/TEN in Asian populations. Thus, we analyzed the registration databases from multiple Asian countries who were treated during 1998-2017. A total 1,028 SJS/TEN cases were identified with the algorithm of drug causality for epidermal necrolysis. Furthermore, those medications labeled by the US Food and Drug Administration (FDA) as carrying a risk of SJS/TEN were also compared with the common causes of SJS/TEN in Asian countries. Oxcarbazepine, sulfasalazine, COX-II inhibitors, and strontium ranelate were identified as new potential causes. In addition to sulfa drugs and beta-lactam antibiotics, quinolones were also a common cause. Only one acetaminophen-induced SJS was identified, while several medications (e.g., oseltamivir, terbinafine, isotretinoin, and sorafenib) labeled as carrying a risk of SJS/TEN by the FDA were not found to have caused any of the cases in the Asian countries investigated in this study.

Matched MeSH terms: Antipsychotic Agents/adverse effects

Fulltext Brief acute psychosis following hysterectomy in ethnopsychiatric context

Tsoh JM, Leung HC, Ungvari GS, Lee DT

Singapore Med J, 2000 Jul;41(7):359-62.

PMID: 11026805

The psychiatric morbidity following hysterectomy has received increasing attention. One of the sequelae of hysterectomy has been a brief, acute psychosis with excellent outcome, the etiology and pathomechanism of which is still unclear. Two Chinese patients born of Southeast Asian origin who manifested brief, acute psychosis following hysterectomy are presented. Therapy comprised drug treatment with low dose antipsychotics and benzodiazepines coupled with hypnosis and marital therapy to explore and treat the underlying pathology. Both psychotic states resolved. Follow-up at 12 months revealed stable mental condition in one subject; however, the second patient was lost to follow up. The impact of the womb's removal is explored in the context of the ethnicity of the patients and their sociocultural background.

Matched MeSH terms: Antipsychotic Agents/therapeutic use

Schizophrenia and Nicotine Dependence: What Psychopharmacological Treatment Options are Available for the Duo Perturbationes?

Theng YM, Wahab S, Wahab NAA, Sidi H, Das S

Curr Drug Targets, 2019;20(2):173-181.

PMID: 29046149 DOI: 10.2174/1389450118666171017163741

Nicotine dependence has progressively become a foremost community health interest in both the developed and developing nations due to the economic burden and health-related problems. Smoking was significantly higher among patients with schizophrenia in comparison to the general population. Nicotine dependence is not only associated with public stress, but among patients with schizophrenia, smoking brings major challenges to the management. Nicotine may diminish the therapeutic efficacy of the bioavailability of the psychopharmacological agents in-vivo. These duo perturbations, i.e. two clinical conditions co-existed may prevent psychotic symptoms remission among patients suffering from schizophrenia who smoke at the same time. The aim of this review was to highlight the role of pharmacological treatment options and strategies for patients with nicotine dependence in schizophrenia with emphasis on the underlying neurobiological process. The role of nicotine replacement therapy, i.e. norepinephrine-dopamine reuptake inhibition (NDRI) e.g. bupropion and selective partial agonist of α4β2 and full α7-nicotinic acetylcholine receptor e.g. varenicline was deliberated. An ideal choice of drug targets for patients with schizophrenia with nicotine dependence is pivotal to foster a better therapeutic alliance.

Matched MeSH terms: Antipsychotic Agents/pharmacokinetics; Antipsychotic Agents/therapeutic use*

Fulltext Clozapine-induced constipation: a case report

Teh, Y.W., Teh, E.E., Russell, V.

Malaysian Journal of Psychiatry, 2014;23(1):77-80.

MyJurnal

Clozapine is an atypical antipsychotic medication, used primarily as the drug of choice in treatment resistant schizophrenia. Despite its considerable advantages, clozapine’s licence is restricted because of its potential to induce agranulocytosis. Hence, white blood cell count monitoring is mandatory in patients receiving clozapine treatment. A side effect of clozapine that has received relatively less attention is constipation, which is caused by the drug’s anticholinergic effect. This potentially serious problem can result in life- threatening bowel obstruction, ischemia, necrosis, perforation, and pulmonary aspiration. Despite this evidence, routine inquiry about constipation in clozapine treated patients is not emphasised in current clinical guidance. We report a case to highlight constipation as both a potentially serious side effect and as a factor, insufficiently recognised, in non-adherence to clozapine.

Matched MeSH terms: Antipsychotic Agents

Fulltext Atypical antipsychotic induced obsessive-compulsive symptoms

Teh EE, Najib MAM

Med J Malaysia, 2004 Dec;59(5):690-1.

PMID: 15889578

Matched MeSH terms: Antipsychotic Agents/administration & dosage*; Antipsychotic Agents/adverse effects*

Comparative bioavailability of two risperidone orodispersible tablet products after single dose administration

Tassaneeyakul W, Kumar S, Gaysonsiri D, Kaewkamson T, Khuroo A, Tangsucharit P, et al.

Int J Clin Pharmacol Ther, 2010 Sep;48(9):614-20.

PMID: 20860915

OBJECTIVES: To compare the bioavailability of two risperidone orodispersible tablet products, Risperidone 1 mg Mouth dissolving tablet, Ranbaxy (Malaysia) Sdn. Bhd., Malaysia, as a test product and Risperdal 1 mg Quicklet, Janssen Ortho LLC, Gurabo, Puerto Rico, as a reference product, in healthy male volunteers under fasting condition.

MATERIALS AND METHODS: A randomized, 2-treatment, 2-period, 2-sequence, single dose, crossover with a washout period of 2 weeks, was conducted in 24 healthy Thai male volunteers. Blood samples were collected at 0, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 24, 36, 48, 72 and 96 h following drug administration. Plasma concentrations of risperidone and 9-hydroxyrisperidone were determined using a validated LC-MS-MS method. The pharmacokinetic parameters of risperidone and 9-hydroxyrisperidone were determined using a non-compartmental model.

RESULTS: The geometric means ratios (%) and 90% confidence interval (CI) of the test and reference products for the log-transformed pharmacokinetic parameters, Cmax, AUC0-t and AUC0-inf of risperidone were 104.49 % (92.79% - 117.66%), 100.96 % (92.15% - 110.61 %) and 97.99 % (90.72% - 105.85%). The 90% CI of geometric means ratios of the test and reference products for the log-transformed pharmacokinetic parameters, Cmax, AUC0-t and AUC0-inf of 9-hydroxyrisperidone were 97.00%, 96.97% and 97.49%.

CONCLUSIONS: The 90% CI for the geometric means ratios (test/reference) of the log-trasformed Cmax, AUC0-t and AUC0-inf of risperidone and its major active metabolite were within the bioequivalence acceptance criteria of 80% - 125% of the US-FDA.

Matched MeSH terms: Antipsychotic Agents/pharmacokinetics*

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