Displaying publications 61 - 80 of 129 in total

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  1. Masiran R
    BMJ Case Rep, 2017 Oct 04;2017.
    PMID: 28978587 DOI: 10.1136/bcr-2017-220817
    We report a case in a young man who developed acute, persistent and painful tongue protrusion followed by swelling for more than 24 hours. He had relapse symptoms of schizophrenia and had recently received a single dose of parenteral haloperidol to manage his agitation. His record showed history of similar event and he has been taking atypical antipsychotic for maintenance. Mental state examination on admission revealed an agitated man with disorganised speech, restricted affect, auditory hallucination and persecutory delusion. His dystonia and oedema improved after 3 days. His mental status also recovered with the maintenance of low-potency antipsychotic and anticholinergic antiparkinsonian medications.
    Matched MeSH terms: Antipsychotic Agents/adverse effects*
  2. Mohd Fadzli, M.I., Nazariah, H., Aili, H.H.
    MyJurnal
    Clozapine is an effective anti-psychotic and has long been used as an intervention for treatment-resistant schizophrenia. This case report will highlight the use of Clozapine up to 100 mg ON as a second-line medication to achieve satisfactory response after 5 weeks in an adolescent who was recently diagnosed with schizophrenia.
    Matched MeSH terms: Antipsychotic Agents
  3. Muhammad Chanchal Azad, Raihana Musawwir
    MyJurnal
    Galactorrhoea is non-lactational milk production and it may or may not be associated with prolactinemia1. It causes embarrassment and distress to a schizophrenic patient, especially, if the patient is male. One study in Germany reported that incidence and prevalence of galactorrhoea in schizophrenia are 14% and 19%, respectively2. Although galactorrhoea is not rare in schizophrenic patients, managing and understanding the a etiology can be problematic. In psychiatric patients, antipsychotics can be a cause but other causes need to be ruled out. Galactorrhoea also needs to be differentiated from pathologic nipple discharge which can be due to breast tumours. Usually, galactorrhoea is bilateral, multiductal, and milky, but discharge can be yellow, green or brown3. This case report describes a 32-year old patient with schizophrenia who visited a government psychiatric hospital in Kota Kinabalu, Sabah, Malaysia. This report highlights the clinical challenges to determine the aetiology of galactorrhoea and to manage it in schizophrenics. It raises the following clinical questions: Why a psychiatric patient develops galactorrhoea? How a schizophrenic patient presents with galactorrhoea? What hormonal imbalances are associated with this psychiatric disorder? How should a doctor handle a schizophrenic patient complaining of galactorrhoea? What is the danger of having galactorrhoea in a male?
    Matched MeSH terms: Antipsychotic Agents
  4. Ng CG, Mohamed S, Wern TY, Haris A, Zainal NZ, Sulaiman AH
    Asian Pac J Cancer Prev, 2014;15(10):4261-4.
    PMID: 24935381
    OBJECTIVE: To examine the prescription rates in cancer patients of three common psychotropic drugs: anxiolytic/ hypnotic, antidepressant and antipsychotic.

    MATERIALS AND METHODS: In this retrospective cohort study, data were extracted from the pharmacy database of University Malaya Medical Center (UMMC) responsible for dispensing records of patients stored in the pharmacy's Medication Management and Use System (Ascribe). We analyzed the use of psychotropics in patients from the oncology ward and cardiology from 2008 to 2012. Odds ratios (ORs) were adjusted for age, gender and ethnicity.

    RESULTS: A total of 3,345 oncology patients and 8,980 cardiology patients were included. Oncology patients were significantly more often prescribed psychotropic drugs (adjusted OR: anxiolytic/hypnotic=5.55 (CI: 4.64-6.63); antidepressants=6.08 (CI: 4.83-7.64) and antipsychotics=5.41 (CI: 4.17-7.02). Non-Malay female cancer patients were at significantly higher risk of anxiolytic/hypnotic use.

    CONCLUSIONS: Psychotropic drugs prescription is common in cancer patients. Anxiolytic/hypnotic prescription rates are significantly higher in non-Malay female patients in Malaysia.

    Matched MeSH terms: Antipsychotic Agents/therapeutic use
  5. Ng CG, Chan PL, Said MA
    MyJurnal
    Introduction: Second generation antipsychotic (SGA) was linked to increased risk of metabolic syndrome. The risk varies between different SGA. We aim to study this risk by examining the co-prescription of antihypertensive, antidiabetic and lipid lowering drugs in patients prescribed with either aripiprazole, quetiapine or clozapine.
    Methods: This is a retrospective cohort study based on the prescription records of a teaching hospital. Prescription records between January 1, 2013 and December 31, 2014 for
    psychiatric unit were extracted. Patients with at least one prescription of any antipsychotic were included. The odds of antihypertensive, antidiabetic and lipid lowering drugs co-prescription in patients with either aripiprazole, quetiapine or clozapine were calculated.
    Results: Of the 1742 study subjects, 88 patients were prescribed with aripiprazole, 175 patients with clozapine and 124 patients with quetiapine. Patients prescribed with quetiapine had
    higher odds of co-prescribed with antihypertensive (OR = 1.71, 95% CI = 1.11, 2.63), antidiabetic drugs (OR = 1.81, 95% CI = 1.11, 2.95) and lipid lowering drugs (OR = 1.94, 95% CI = 1.19, 3.16). There were higher odds of co-prescription of antihypertensive (OR = 1.54, 95% CI = 1.05, 2.25), antidiabetic drugs (OR = 1.69, 95% CI = 1.10, 2.59) and lipid lowering drugs
    (OR = 1.90, 95% CI = 1.24, 2.91) in patients with clozapine. However, there were no increase odds of co-prescription of the three agents in patients with aripiprazole.
    Conclusion: We need to monitor the risk of metabolic syndrome in patients treated with SGA. Aripiprazole has lower risk of metabolic syndrome.
    Matched MeSH terms: Antipsychotic Agents
  6. Ng, C.G., Yee, H.A., Zainal, N.Z., Loh, H.S.
    MyJurnal
    Objective: The aim of the study was to determine the early readmission rate among the psychiatric patients discharged from a teaching hospital in Malaysia. The associated factors were also examined. Methods: This is a prospective and observational study. The socio-demographic and clinical data of 202 patients from the psychiatric ward were collected on discharge along with the administration of instruments including Brief Psychiatric Rating Scale (BPRS), Life Events Questionnaire (LEQ), and Multidimensional Scale of Perceived Social Support (MSPSS). Assessment of compliance to medication and substance use was reliant on self-report data. Medication compliance was categorized as “poor” vs “good”, whereas poor compliance was the complete discontinuation of medication for at least two weeks. The patients were followed up to determine whether they were readmitted within 6 months. Results: At the end of 6 months follow-up, 32.2% of the subjects were readmitted. Univariate regression analysis indicated that patients with psychotic disorder, past episodes, previous admission, poor compliance, on conventional or depot injectable antipsychotic and higher BPRS scores on discharge were significantly associated with early readmission (p
    Matched MeSH terms: Antipsychotic Agents
  7. Ng, C.G., Seed, H.F., Thong, K.S.
    MyJurnal
    Introduction: Atypical antipsychotic drugs are effective in the treatment of bipolar disorder. Studies have shown that atypical antipsychotic drugs are more superior to typical antipsychotic in term of neurocognitive function, negative symptoms and extrapyramidal side effects. Both aripiprazole and quetiapine are atypical antipsychotic drugs that are effective and commonly used in all phases of bipolar disorder treatment. Objective: The aim of this study is to examine and compare the clinical outcomes of aripiprazole and quetiapine in bipolar disorder patients. Method: This was a retrospective cohort study among patients from psychiatric unit, University Malaya Medical Center. Prescription records dated between January 1, 2013 and December 31, 2014 for psychiatric unit were extracted. The data of the subjects with prescription of the two atypical antipsychotic, namely aripiprazole and quetiapine was extracted. The outcome measures were the co-prescription of antihypertensive drugs, antidiabetic drugs and lipid lowering drugs. Results: A total of 58 subjects were recruited, 11 were on aripiprazole and 47 were on quetiapine. Statistical analysis has shown that both aripiprazole and quetiapine do not have any association with compliance to the medication and also follow up. Study also revealed that there is no association between the aripiprazole and quetiapine group with the metabolic side effects that were measured such as systolic or diastolic blood pressure, waist circumference, weight, glucose level and body mass index. Conclusion: This study has shown that both aripiprazole and quetiapine were similar in terms of metabolic side effect, compliance to medications and follow up.
    Matched MeSH terms: Antipsychotic Agents
  8. Nguyen TA, Pham T, Vu HTT, Nguyen TX, Vu TT, Nguyen BTT, et al.
    Am J Alzheimers Dis Other Demen, 2018 Nov;33(7):423-432.
    PMID: 29642720 DOI: 10.1177/1533317518768999
    This study examined the use of potentially inappropriate medicines that may affect cognition (PIMcog) in people with dementia and its associated factors. Medical records of all outpatients with dementia attending a tertiary hospital in Vietnam between January 1, 2015, and December 31, 2016, were examined. Medicine use was assessed against a list of PIMcog. Variables associated with having a PIMcog were assessed using a multiple logistic regression. Of the 128 patients, 41% used a PIMcog, 39.1% used cholinesterase inhibitors (CEIs) concomitantly with anticholinergics, and 18% used antipsychotics. The number of hospital visits (adjusted odds ratio [OR]: 1.08; 95% confidence interval [CI]: 1.02-1.16) and number of treating specialists (adjusted OR: 0.61; 95% CI: 0.45-0.83) were associated with PIMcog use. This study highlights a high-level use of medicines that can further impair cognition or reduce the effectiveness of CEIs in people with dementia. Efforts to improve quality use of medicines for this population are warranted.
    Matched MeSH terms: Antipsychotic Agents/administration & dosage*; Antipsychotic Agents/adverse effects
  9. Nik Ruzyanei, N.J., Hazli, Z., Chong, Y.S.
    MyJurnal
    Introduction: The use of long acting injectable (LAI) antipsychotics is mainly reserved as the second line treatment when all efforts to ensure patients’ adherence to regular oral medication failed. We aim to describe the common clinical features of patients with schizophrenia who benefited from the use of LAI early in the course of illness. Methods: We report four patients with first presentation of schizophrenia, all of whom were started with atypical LAI antipsychotics without prior history of oral antipsychotic. Results: In all of the cases, short acting major tranquilizers were not administered in the acute phase of psychosis because the patients were not agitated. Beside absence of agitation, other common clinical features observed in the four patients were prominent delusion (rather than hallucination), obstinate refusal of oral medication, good pre-morbid functioning and very poor insight. Interestingly, following the remission of the acute psychotic phase, all showed marked improvement in their insight and had better than expected therapeutic alliance. Discussion: LAI may improve the doctor-patient therapeutic alliance due to its minimal side effects and by ways of increasing the patients’ sense of control and allowing psychoeducation to take place when the patient is ready. We conclude that LAI may be used as the first line antipsychotic treatment in the acute psychotic phase in patients who are nonagitated but have prominent symptom of delusions with poor insight.
    Matched MeSH terms: Antipsychotic Agents
  10. Norlelawati AT, Kartini A, Norsidah K, Ramli M, Wan Azizi WS, Tariq AR
    Asia Pac Psychiatry, 2015 Mar;7(1):45-53.
    PMID: 23857669 DOI: 10.1111/appy.12089
    INTRODUCTION: The present study investigated the relationship between psychological symptoms and psychosocial function and the role of relevant sociodemographic data and antipsychotic use in the prediction of psychosocial function among multiracial schizophrenia outpatients in Malaysia.
    METHODS: A total of 223 participants were recruited in this cross-sectional study conducted from December 2010 to April 2011. Psychological symptoms were assessed using the Positive and Negative Syndrome Scale whilst the psychosocial function was assessed using the Personal and Social Performance scale. Sociodemographic and treatment variables were gathered through interview or review of the medical records.
    RESULTS: All dimensions of psychosocial functions were inversely correlated with Positive and Negative Syndrome Scale sub-domains. Only the disorganization sub-domain significantly predicts all dimensions of psychosocial function. For social data, body mass index and employment status were significant predictors of all dimensions of psychosocial functions. Typical antipsychotics significantly predict social function negatively as compared to sulpiride (β = -0.152, P = 0.028).
    DISCUSSION: We found that the relationship between psychological symptoms and psychosocial functions were relatively consistent with the findings from the Caucasian population. Additionally, disorganization was the only significant predictor of all dimensions of psychosocial functions. This further emphasized the importance of cognition in psychosocial function. The roles of sulpiride, body mass index and employment status as predictors of psychosocial function were also discussed.
    KEYWORDS: antipsychotics; psychosocial function; schizophrenia; symptoms
    Study site: Psychiatric clinic, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia
    Matched MeSH terms: Antipsychotic Agents/therapeutic use*
  11. Norlelawati AT, Kartini A, Ramli M, Norsidah K, Wan Azizi WS, Tariq AR
    East Asian Arch Psychiatry, 2012 Jun;22(2):49-56.
    PMID: 22714874
    OBJECTIVES. Obesity is an issue of concern among patients with schizophrenia as it is a co-morbid condition that is closely related to metabolic syndrome. The present study assessed the correlation of body mass index with antipsychotic use among multiracial schizophrenia outpatients. The study also compared the patients' body mass index with Malaysian Adult Nutrition Survey (MANS) data.
    METHODS. A total of 216 participants were recruited into a cross-sectional study conducted over 5 months, from December 2010 to April 2011. Body weight and height were measured using the standard methods. Demographic data and treatment variables were gathered through interview or review of the medical records.
    RESULTS. There were differences in mean body mass index between men and women (p = 0.02) and between Malay, Chinese and Indian races (p = 0.04). Stratified by sex, age, and race, the body mass index distributions of the patients were significantly different to those of the reference MANS population. The prevalence of obesity among patients was more than 2-fold greater than among the reference population in all variables. Although body mass index distribution was related to antipsychotic drugs (χ(2) = 33.42; p = 0.04), obesity could not be attributed to any specific drug.
    CONCLUSION. The prevalence of obesity among patients with schizophrenia was significantly greater than that in the healthy Malaysian population, and affects the 3 main races in Malaysia.
    Study site: Psychiatry Clinic, Tengku Ampuan Afzan Hospital, Kuantan, Pahang, Malaysia.
    Matched MeSH terms: Antipsychotic Agents/administration & dosage; Antipsychotic Agents/adverse effects*
  12. Normala I, Hamidin A
    Med J Malaysia, 2009 Sep;64(3):240-1.
    PMID: 20527278 MyJurnal
    The use of atypical antipsychotic agents in early onset schizophrenia is rising despite its limited data on efficacy, safety and tolerability. Early onset schizophrenia warrants effective pharmacological treatment that is safe and well tolerated by children and adolescent population. Existing atypical agents are not completely free of side effects. Aripiprazole has unique properties that differ from other atypical antipsychotics and fill up the missing gaps, as it is associated with minimal metabolic complications and extrapyramidal side effects that are more commonly seen in other atypical agents. It offers a better option for this population and may possibly be considered as first line treatment in future. This case report demonstrates the efficacy and safety of Aripiprazole in children and adolescent population.
    Matched MeSH terms: Antipsychotic Agents/adverse effects; Antipsychotic Agents/therapeutic use*
  13. Norzila Zakaria, Mohd Jamil Yaacob, Hans, Van Rostenberghe
    ASEAN Journal of Psychiatry, 2009;10(2):199-201.
    MyJurnal
    Objective: To report the use of Paliperidone in an adolescent with bipolar disorder primarily concerning its effectiveness and safety. Method: We present a case report of an adolescent with atypical presentation of bipolar disorder. The problem was complicated by poor liver function and poor compliance. Progress of the patient was recorded. Results: The patient showed dramatic improvement after 2 weeks on Paliperidone and has achieved the best level of functioning after almost 4 years on other treatment. Conclusion: The usage of Paliperidone was effective and safe in an adolescent with atypical bipolar disorder.
    Matched MeSH terms: Antipsychotic Agents
  14. Nour El Huda AR, Norsidah KZ, Nabil Fikri MR, Hanisah MN, Kartini A, Norlelawati AT
    Psychiatry Clin Neurosci, 2018 Apr;72(4):266-279.
    PMID: 29160620 DOI: 10.1111/pcn.12622
    AIM: This study examined catechol-O-methyltransferase (COMT) DNA methylation in the peripheral blood of schizophrenia patients and also in healthy controls to investigate its potential use as a peripheral biomarker of schizophrenia and its relations with the clinical variables of schizophrenia patients.

    METHODS: We examined the DNA methylation levels of COMT using genomic DNA from the peripheral blood of schizophrenia patients (n = 138) and healthy control participants (n = 132); all were Malaysian Malays. The extracted DNA was bisulfite converted, and the percentage methylation ratio value was calculated based on the results following a MethyLight protocol analysis.

    RESULTS: The percentage methylation ratio of COMT was lower in schizophrenia than it was in the healthy controls (P 

    Matched MeSH terms: Antipsychotic Agents/pharmacology*
  15. Nour El Huda Abd Rahim, Mohd Nabil Fikri Rahim, Norsidah Ku Zaifah, Hanisah Mohd Noor, Kartini Abdullah, Norlelawati A. Talib
    MyJurnal
    The dopamine hypothesis has earlier dominated the theories for the
    development of schizophrenia based on the early pharmacologic evidence. The
    antipsychotic drugs, among others, is thought to interfere with the function of the
    dopamine D2 receptor (DRD2) resulting in clinical improvement. Accumulating evidence
    suggest the role of epigenetic mechanisms in the pathophysiology of schizophrenia.
    Despite this, specific evidence linking the DRD2 DNA methylation with schizophrenia is
    insufficient mainly due to the poor accessibility and limited brain samples. Of late, new
    data has suggested the global impact of DNA methylation in the development of
    schizophrenia, thus methylation in the peripheral blood could infer changes in the brain.
    The aim of this study was to assess the DRD2 DNA methylation in the peripheral blood of
    schizophrenia.
    Matched MeSH terms: Antipsychotic Agents
  16. Nour El Huda Abd Rahim, Mohd Nabil Fikri Rahim, Norsidah Ku Zaifah, Hanisah Mohd Noor, Kartini Abdullah, Norlelawati A. Talib
    MyJurnal
    The dopamine hypothesis of schizophrenia is based on the fact that hyperdopaminergic
    state is involved in causing psychosis and antipsychotic drugs block the
    dopamine receptor. COMT regulates the homeostatic levels of neurotransmitter
    dopamine in the synapses and plays a role in the neurocognitive function. The
    dysregulation of dopamine in the prefrontal cortex influences the cognitive function and
    the severity of the psychotic symptoms in schizophrenia. During epigenetic event,
    methylated COMT gene may cause reduction in its expression and contribute to the
    clinical presentation of schizophrenia. Therefore, the aim of this study was to assess the
    feasibility of using COMT DNA methylation for the prediction of specific psychotic
    presentation of schizophrenia. (Copied from article).
    Matched MeSH terms: Antipsychotic Agents
  17. Ohn MH, Loo JL, Ohn KM
    BMJ Case Rep, 2021 Feb 04;14(2).
    PMID: 33542006 DOI: 10.1136/bcr-2020-237065
    Atraumatic trismus can be one of the presentations of medication-induced acute dystonia, particularly by antipsychotics and less commonly antidepressants. A case of an unusual emergency presentation of atraumatic trismus on initiation of duloxetine is reported. The patient was a 40-year-old woman experiencing sudden difficulty in mouth opening and speaking due to a stiffened jaw after taking 5 days of duloxetine prescribed for her fibromyalgia-related chest pain. Assessment of vital signs is prudent to ensure there is no laryngeal involvement. Other physical examinations and her recent investigations were unremarkable. She was treated for acute dystonia and intravenous procyclidine was given together with oral diazepam. Her symptoms improved immediately and her duloxetine was suggested to be stopped. To our knowledge, this is the first case of isolated trismus induced by duloxetine. Clinicians should be aware of this risk, especially considering the limitation of important physiological functions (such as swallowing, eating, etc) associated with this condition.
    Matched MeSH terms: Antipsychotic Agents/administration & dosage; Antipsychotic Agents/adverse effects
  18. Ong CE, Teh LK, Ismail R
    Med J Malaysia, 2002 Jun;57(2):251-60.
    PMID: 24326665
    Drug interactions can cause iatrogenic disease. If concurrent medications are taken, the potential exists for a drug interaction to occur. Renewed interest in the topic interactions has been generated by the fatal interactions involving non-sedating histamine H-1 antagonists and the recent intriduction of two therapeutic agents, the selective serotonin reuptake inhibitors (SSRIs) and HIV protease inhibitors, for the treatment of depression and AIDS, respectively. These three therapeutic agents have been implicated in clinically significant drug interactions. The consequences of these interactions vary in clinical significance, extent, and effect. Some interactions are theoretical whereas others may lead to severe iatrogenic adverse experiences including lethal consequences.The purpose of this review is to alert the medical practioner to potential drug interactions that may occur when these drugs are prescribed to patients. The pharmacological basis and clinical signficance of these interactions are reviewed. The pharmacological mechanisms underlying these interactions are illustrative of those that may be involved for many other medications. Doctors should be aware of the potential pitfall that may occur when certain groups of drugs are prescribed with concurrent medications.
    Matched MeSH terms: Antipsychotic Agents
  19. Pandy V, Narasingam M, Mohamed Z
    PMID: 23082808 DOI: 10.1186/1472-6882-12-186
    Noni fruit is widely consumed in tropical regions of Indonesia to the Hawaiian Islands. The noni plant has a long history of use as a medicinal plant to treat a wide variety of ailments including CNS disorders. The present investigation was designed to evaluate the antipsychotic effect of noni fruits (Morinda citrifolia Linn.) using mouse models of apomorphine-induced climbing behaviour and methamphetamine-induced stereotypy (licking, biting, gnawing and sniffing).
    Matched MeSH terms: Antipsychotic Agents/administration & dosage*
  20. Pandy V, Vijeepallam K
    Exp Anim, 2017 Oct 30;66(4):417-423.
    PMID: 28701621 DOI: 10.1538/expanim.17-0050
    In an earlier report, we demonstrated an antipsychotic-like activity of a methanolic extract of Morinda citrifolia Linn fruit in mouse models and postulated the contribution of its bioactive principles, scopoletin and rutin. Moreover, the antidopaminergic activities of scopoletin and rutin were reported in isolated vas deferens preparations. In the present study, scopoletin and rutin were assessed for antipsychotic-like activity using apomorphine-induced climbing behavior and methamphetamine-induced stereotypy in mice. The results of this study revealed that scopoletin and rutin (0.05, 0.1, 0.5, and 1 mg/kg, p.o.) had a "U-shaped" dose-dependent effect on climbing and stereotyped behaviors induced by apomorphine and methamphetamine, respectively, in mice. A significant reduction in climbing and stereotyped behaviors caused by scopoletin and rutin was observed only at a dose 0.1 mg/kg. This study suggests that scopoletin and rutin can alleviate positive symptoms of schizophrenia only at a specific dose. Further studies evaluating the effects of scopoletin and rutin on animal models for negative symptoms of schizophrenia are required for a novel drug discovery in the treatment of neuropsychiatric diseases.
    Matched MeSH terms: Antipsychotic Agents*
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