The effect of age on the pharmacological management of ambulatory patients treated with depot neuroleptic medications for schizophrenia and related psychotic disorders

David C. Mamo; Robert A. Sweet; K. N. Roy Chengappa; Ravinder R. Reddy; Dilip V. Jeste

doi:10.1002/gps.740

Antipsychotic-induced extrapyramidal side effects: A systematic review and meta-analysis of observational studies

PLoS ONE ◽

10.1371/journal.pone.0257129 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0257129

Author(s):

Tilahun Ali ◽

Mekonnen Sisay ◽

Mandaras Tariku ◽

Abraham Nigussie Mekuria ◽

Assefa Desalew

Keyword(s):

Systematic Review ◽

Side Effects ◽

Tardive Dyskinesia ◽

Publication Bias ◽

Psychotic Disorders ◽

Meta Analysis ◽

Extrapyramidal Side Effects ◽

Bias Analysis ◽

Pharmacological Management ◽

Early Management

Background Antipsychotic agents are the basis for the pharmacological management of acute and chronic schizophrenia, bipolar disorders, mood disorders with psychotic feature, and other psychotic disorders. Antipsychotic medication use is frequently associated with unfavorable adverse effects such as extrapyramidal side effects (EPSEs). Hence, this systematic review and meta-analysis was aimed to determine the magnitude of antipsychotic-induced EPSEs. Method A literature search was conducted using legitimate databases, indexing services, and directories including PubMed/MEDLINE (Ovid®), EMBASE (Ovid®), google scholar and WorldCat to retrieve studies. Following screening and eligibility, the relevant data were extracted from the included studies using an Excel sheet and exported to STATA 15.0 software for analyses. The Random effects pooling model was used to analyze outcome measures at a 95% confidence interval. Besides, publication bias analysis was conducted. The protocol has been registered on PROSPERO with ID: CRD42020175168. Result In total, 15 original articles were included for the systematic review and meta-analysis. The pooled prevalence of antipsychotic-induced EPSEs among patient taking antipsychotic medications was 37% (95% CI: 18–55%, before sensitivity) and 31% (95% CI: 19–44%, after sensitivity). The prevalence of antipsychotic-induced parkinsonism, akathisia, and tardive dyskinesia was 20% (95% CI: 11–28%), 11% (95% CI: 6–17%), and 7% (95% CI: 4–9%), respectively. To confirm a small-study effect, Egger’s regression test accompanied by funnel plot asymmetry demonstrated that there was a sort of publication bias in studies reporting akathisia and tardive dyskinesia. Conclusion The prevalence of antipsychotic-induced EPSEs was considerably high. One in five and more than one in ten patients experienced parkinsonism and akathisia, respectively. Appropriate prevention and early management of these effects can enhance the net benefits of antipsychotics.

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The Pharmacological Management of Behavioural Disturbance in Psychosis: a Naturalistic Study

Australasian Psychiatry ◽

10.1080/10398560701435754 ◽

2007 ◽

Vol 15 (5) ◽

pp. 380-384 ◽

Cited By ~ 5

Author(s):

Jeffrey Daniel ◽

James Chamberlain ◽

David Castle

Keyword(s):

Pharmacological Treatment ◽

Psychotic Disorders ◽

Comparable Efficacy ◽

Naturalistic Study ◽

Behavioural Disturbance ◽

Royal Melbourne Hospital ◽

Pharmacological Management ◽

Significant Difference ◽

Naturalistic Setting ◽

Efficacy Measures

Objective: The aim of the study was to compare the efficacy of atypical and typical anti-psychotics in treating behavioural disturbance in people with psychotic disorders, in a naturalistic setting. Method: This was a prospective naturalistic study of 303 incidents of behavioural disturbance at Royal Melbourne Hospital, Melbourne, Victoria, Australia. Results: There was no significant difference between atypicals and typicals on two efficacy measures and some evidence on a third measure, that typicals are more effective. Conclusions: In the pharmacological treatment of behavioural disturbance in psychosis, typical and atypical anti-psychotics have largely comparable efficacy.

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Psychosocial Risks and Management for Children and Adolescents With 22q11.2 Deletion Syndrome

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig5-2019-0002 ◽

2019 ◽

Vol 4 (4) ◽

pp. 633-640 ◽

Cited By ~ 1

Author(s):

Canice E. Crerand ◽

Ari N. Rabkin

Keyword(s):

Cognitive Abilities ◽

Psychotic Disorders ◽

Developmental Stages ◽

Early Adulthood ◽

22Q11.2 Deletion Syndrome ◽

Deletion Syndrome ◽

22Q11.2 Deletion ◽

Psychosocial Risks ◽

Empirically Supported ◽

Specific Education

Purpose This article reviews the psychosocial risks associated with 22q11.2 deletion syndrome, a relatively common genetic condition associated with a range of physical and psychiatric problems. Risks associated with developmental stages from infancy through adolescence and early adulthood are described, including developmental, learning, and intellectual disabilities as well as psychiatric disorders including anxiety, mood, and psychotic disorders. Other risks related to coping with health problems and related treatments are also detailed for both affected individuals and their families. Conclusion The article ends with strategies for addressing psychosocial risks including provision of condition-specific education, enhancement of social support, routine assessment of cognitive abilities, regular mental health screening, and referrals for empirically supported psychiatric and psychological treatments.

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Assessing Mental and Behavioral Disorder Impairment: Overview of Sixth Edition Approaches

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2008.novdec01 ◽

2008 ◽

Vol 13 (6) ◽

pp. 1-7

Author(s):

Norma Leclair ◽

Steve Leclair ◽

Robert Barth

Keyword(s):

Mental Disorders ◽

Behavioral Disorders ◽

Psychotic Disorders ◽

Behavioral Disorder ◽

Behavioral Impairment ◽

Central Nervous System Damage ◽

Brain Functioning ◽

Sixth Edition ◽

Diagnostic And Statistical Manual ◽

Mental And Behavioral Disorders

Abstract Chapter 14, Mental and Behavioral Disorders, in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, defines a process for assessing permanent impairment, including providing numeric ratings, for persons with specific mental and behavioral disorders. These mental disorders are limited to mood disorders, anxiety disorders, and psychotic disorders, and this chapter focuses on the evaluation of brain functioning and its effects on behavior in the absence of evident traumatic or disease-related objective central nervous system damage. This article poses and answers questions about the sixth edition. For example, this is the first since the second edition (1984) that provides a numeric impairment rating, and this edition establishes a standard, uniform template to translate human trauma or disease into a percentage of whole person impairment. Persons who conduct independent mental and behavioral evaluation using this chapter should be trained in psychiatry or psychology; other users should be experienced in psychiatric or psychological evaluations and should have expertise in the diagnosis and treatment of mental and behavioral disorders. The critical first step in determining a mental or behavioral impairment rating is to document the existence of a definitive diagnosis based on the current edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. The article also enumerates the psychiatric disorders that are considered ratable in the sixth edition, addresses use of the sixth edition during independent medical evaluations, and answers additional questions.

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Errata

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2008.marapr02 ◽

2008 ◽

Vol 13 (2) ◽

pp. 5-5

Keyword(s):

Psychotic Disorders ◽

Pain Syndrome ◽

Vestibular Disorders ◽

Loss Of Function ◽

Sixth Edition ◽

Neurologic Disorders ◽

Upper And Lower Extremities ◽

Impairment Ratings ◽

Extensive List ◽

Mental And Behavioral Disorders

Abstract Although most chapters in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, instruct evaluators to perform impairment ratings by first assigning a diagnosis-based class and then assigning a grade within that class, Chapter 13, The Central and Peripheral Nervous System, continues to use a methodology similar to that of the fifth edition. The latter was criticized for duplicating materials that were presented in other chapters and for producing different ratings, so the revision of Chapter 13 attempts to maintain consistency between this chapter and those that address mental and behavioral disorders, loss of function in upper and lower extremities, loss of bowel control, and bladder and sexual function. A table titled Summary of Chapters Used to Rate Various Neurologic Disorders directs physicians to the relevant chapters (ie, instead of Chapter 13) to consult in rating neurologic disorders; the extensive list of conditions that should be addressed in other chapters includes but is not limited to radiculopathy, plexus injuries and other plexopathies, focal neuropathy, complex regional pain syndrome, visual and vestibular disorders, and a range of primary mood, anxiety, and psychotic disorders. The article comments in detail on sections of this chapter, identifies changes in the sixth edition, and provide guidance regarding use of the new edition, resulting in less duplication and greater consistency.

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