Maintenance Antipsychotic Therapy and Civil Commitment

Психические расстройства ассоциированы с нарушением паттерна изоформ транскриптов экзона II гена HTR2A за счет преобладания альтернативной изоформы Е2-. При этом высокий уровень экспрессии изоформы Е2- ассоциирован с благоприятным прогнозом антипсихотической терапии. The aim of the study was to analyze the role of exon II HTR2A gene transcript isoforms and rs6311 genetic variant in the development of mental pathologies and antipsychotic therapy prognosis. Alternative isoforms of exon II HTR2A are associated with the development of mental pathologies and is applicable to predict antipsychotic therapy outcome.

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Analysis of antipsychotic therapy in outpatients diagnosed with the first episode of schizophrenia

10.26226/morressier.5b68175fb56e9b005965c695 ◽

2018 ◽

Author(s):

Egor Chumakov ◽

Yulia Ashenbrenner ◽

Nataliia Petrova

Keyword(s):

First Episode ◽

Antipsychotic Therapy ◽

First Episode Of Schizophrenia

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Neuropsychiatric Symptoms and Antipsychotic Therapy in the Elderly Patients with Dementia

Psychiatry ◽

10.30629/2618-6667-2020-18-4-6-15 ◽

2020 ◽

Vol 18 (4) ◽

pp. 6-15

Author(s):

I. V. Kolykhalov

Keyword(s):

Neuropsychiatric Symptoms ◽

The Elderly ◽

Psychotic Symptoms ◽

Mixed Dementia ◽

Short Term ◽

Antipsychotic Therapy ◽

Dementia Patients ◽

Frequency Of Use ◽

Number Of Patients ◽

High Incidence

The objective of the study was to investigate syndromal-nosological specificities of neuropsychiatric symptoms (NPS) and the frequency of use of antipsychotics in patients with various types of dementias, institutionalized to geriatric units of mental hospitals.Patients and methods: a total of 106 in-patients of three psychogeriatric units were examined. The median age of patients is 75 years [69; 80].The diagnostic distribution of patients at the time of the examination was as follows: in 33 subjects (31.1%) Alzheimer’s disease (AD) was diagnosed, in 25 (23.6%) - mixed dementia (MD), in 32 (30.2%) - vascular dementia (VD) and in 16 (15.1%) patients had dementia of complex origin (DCO).Results: a high incidence (54.7%) of NPS was found in patients with dementia of various origins. The greatest number of patients with behavioral and psychotic symptoms was found in AD and MD. The proportion of dementia patients with such disorders in each of these types of dementia is about 70%, while in CGD and VD, the proportion of patients with NPS is noticeably smaller (30% and 40%, respectively). For the treatment of NPS, antipsychotics were most often prescribed, but their use caused adverse events (AEs) in 1/3 of cases. Patients with VD are most susceptible to the development of AE, and AD patients are the least susceptible.Conclusion: the study showed that NPS are one of the important components of dementia, regardless of the nosology and stage of the disease. The treatment of NPS in dementia is particularly challenging because, although the symptoms cause significant distress, there are currently no effective alternative therapies. The risk of AE can be minimized by carefully considering the indications for prescribing antipsychotics and their short-term use, regular monitoring of the patient’s condition, and educating caregivers.

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Antipsychotic-induced supersensitivity – A reappraisal

Australian & New Zealand Journal of Psychiatry ◽

10.1177/00048674211025694 ◽

2021 ◽

pp. 000486742110256

Author(s):

William Lugg

Keyword(s):

Tardive Dyskinesia ◽

Significant Proportion ◽

Underlying Mechanism ◽

Antipsychotic Treatment ◽

Physiological Changes ◽

Antipsychotic Therapy ◽

Neurotransmitter Systems ◽

Potential Benefits ◽

Treatment Refractory ◽

Brain Pathways

Objectives: Tardive dyskinesia, psychotic relapse and treatment-refractory psychosis have long been associated. A common underlying mechanism involving antipsychotic-induced ‘supersensitivity’, albeit in different brain pathways, was proposed as early as 1978. This piece seeks to reappraise the concept and potential implications of antipsychotic-induced supersensitivity. Conclusions: Evidence increasingly suggests that chronic antipsychotic exposure induces neuroadaptive physiological changes in dopaminergic, and other, neurotransmitter systems that may render some individuals more vulnerable to psychotic relapse - including those receiving continuous antipsychotic treatment. It is possible that in treating every episode of psychosis with prolonged or indefinite antipsychotic therapy, we paradoxically increase the risk of psychotic relapse in a significant proportion of people. A greater appreciation of supersensitivity may allow us to optimise any potential benefits of antipsychotics while minimising the risk of inadvertent iatrogenic harms. More research is needed to improve our understanding of the underlying neurophysiology of supersensitivity and to better identify which individuals are most vulnerable to its development. It is time we paid more attention to the concept, emerging evidence and potential implications of antipsychotic-induced supersensitivity and, where appropriate, adjusted our practice accordingly.

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