scholarly journals Off-label antipsychotic use and tardive dyskinesia in at-risk popu lations: new drugs with old side effects

2014 ◽  
Vol 39 (1) ◽  
pp. E1-E2 ◽  
Author(s):  
Gary Remington ◽  
Margaret Hahn
Keyword(s):  
At Risk ◽  
Side Effects ◽  
Tardive Dyskinesia ◽  
New Drugs ◽  
Off Label ◽  
Popu Lations

The Science of Antipsychotics: Mechanistic Insight

CNS Spectrums ◽  
2003 ◽  
Vol 8 (S2) ◽  
pp. 5-9 ◽  
Author(s):  
Carol A. Tamminga
Keyword(s):  
Side Effects ◽  
Tardive Dyskinesia ◽  
Side Effect ◽  
Negative Symptoms ◽  
New Drugs ◽  
Receptor Subtypes ◽  
Side Effect Profile ◽  
Cognitive Symptoms ◽  
Conventional Antipsychotics ◽  
New Antipsychotics

ABSTRACTWith the introduction of conventional antipsychotics in the 1950s, clinicians began to expect effective treatment of positive symptoms of schizophrenia. However, these drugs do not resolve negative and cognitive symptoms of schizophrenia and are also associated with serious side effects, including extrapyramidal side effects (EPS) and tardive dyskinesia. In 1989, clozapine was introduced and labeled the first new antipsychotic owing to its improved efficacy and side-effect profile. Clozapine proved effective in alleviating many of the positive, negative, and cognitive symptoms of schizophrenia, without causing inevitable EPS or tardive dyskinesia. Over the past decade, a number of different new antipsychotics have been developed. These drugs have an affinity for multiple dopamine-receptor subtypes as well as serotonin, norepinephrine, and glutamate receptors, allowing for better treatment outcomes. The antagonism of the 5-HT2A receptor may be responsible for improvement in negative symptoms and decrease in EPS. In addition to providing enhanced efficacy, the affinity of the new drugs for multiple receptors introduces new side effects not seen with the conventional agents, including weight gain. Each new antipsychotic has a unique receptor-binding profile that corresponds to its pharmacologic and side-effect profile. Understanding the differences in mechanisms of action of new antipsychotics will allow physicians to better choose treatment that meets the needs of each individual patient.

Medical Liability for Off Label Use of Drugs in Romania

2018 ◽  
Vol 69 (3) ◽  
pp. 755-757
Author(s):  
Ionut Vida Simiti
Keyword(s):  
Side Effects ◽  
Medical Devices ◽  
Medical Liability ◽  
Criminal Offence ◽  
Off Label Use ◽  
National Agency ◽  
Off Label ◽  
Scientific Support ◽  
The Common ◽  
Label Use

Breaking the limits of the risks for the human body, health or even the life of the patient, as assumed by the pharmaceutical producers, by using a drug off label, for its side effects, in another purpose or even against the purpose for which the drug was authorized by the National Agency of Medicine and Medical Devices, is not in itself illegal if the off label use has the common consent of both the doctor and the patient for a treatment and only for a treatment which, although a spread procedure, has little or no scientific support. But if the patient is subjected to unreasonable risks, endangering his body, health or life beyond the possible benefits of the treatment, without being informed about the lack of scientific support, the doctor is liable not only for malpractice (civil medical liability) but also for a criminal offence.

scholarly journals Quality of life, symptoms and dietary habits in oncology outpatients with malnutrition: A cross-sectional study

2021 ◽  
Vol 38 (2) ◽  
Author(s):  
Mira Sonneborn-Papakostopoulos ◽  
Clara Dubois ◽  
Viktoria Mathies ◽  
Mara Heß ◽  
Nicole Erickson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
At Risk ◽  
Side Effects ◽  
Dietary Habits ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
University Hospital ◽  
Cross Sectional ◽  
European Organization

AbstractCancer-related malnutrition has a high prevalence, reduces survival and increases side effects. The aim of this study was to assess oncology outpatients and risk of malnutrition. Reported symptoms and quality of life (QoL) in patients found to be at risk of malnutrition or malnourished were compared to patients without malnutrition. Using a standardized questionnaire, the European Organization for Research and Treatment of Cancer Questionnaire for Quality of Life and the Mini Nutritional Assessment (MNA), patients in an outpatient cancer clinic undergoing chemotherapy treatment at a German University Hospital were assessed for nutrition, risk of malnutrition and quality of life. Based on the MNA, 39 (45.9%) patients were categorized as malnourished or at risk for malnutrition. Loss of appetite (n = 37.6%, p < 0.001) and altered taste sensation (n = 30,3%, p < 0.001) were the symptoms most frequently associated with reduced food intake. Patients with risk of malnutrition scored lower on the global health status (n = 48.15%, p = 0.001). Side effects of cancer treatments lead to a higher risk of malnutrition and as a consequence lower QoL. These side effects should be addressed more efficiently in cancer care.

scholarly journals Off-label prescribing of quetiapine in south locality crisis teams

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S87-S87
Author(s):  
Mamta Kumari ◽  
Arun Kumar Gupta ◽  
Peter Clarke
Keyword(s):  
Side Effects ◽  
Physical Health ◽  
Health Monitoring ◽  
Treatment Options ◽  
General Medical Council ◽  
Evidence Base ◽  
Medical Council ◽  
Team Members ◽  
Off Label ◽  
Psychotropic Medicines

AimsThe audit was carried out to determine the frequency of off label prescribing of quetiapine and compliance with standards within Trust Policy (UHM PGN 02 PPT PGN 08) – Physical Health Monitoring of Patients Prescribed Antipsychotics and other Psychotropic Medicines, NICE CG178, General Medical Council Ethical Standards and Royal College of Psychiatrists – College Report CR210.The main objectives of the audit were to determine if:Patients have been appropriately informed of off-label status and consent recorded.Alternative licensed treatment first used/ruled out.Appropriate communication on transfer of care.Appropriate physical health monitoring completed.BackgroundQuetiapine is associated with various physical side effects. Patients should be fully informed of the expected risks and benefits of treatment, and the limited evidence base for off-label prescribing.There are additional issues around the transfer of prescribing to primary care.MethodThe sample consisted of 50 consecutive patients selected from the crisis team caseload in the month of December 2018.Data reviewed in this audit were taken from six months period.Records audited were obtained from RiO (electronic records) and prescription charts.Data collection was started in January 2019 and completed in March 2019The audit tool was a dichotomous scale questionnaire based on NICE guidelines.Result4 patients from the sample (8%) were prescribed off-label quetiapine.100% had physical health monitoring completed as per Trust policy.100% off-label indication been clearly documented in notes.100% Consent to treatment was documented.100% had medication reviewed in the previous 6 months.75% had licensed medication used or ruled out before considering off-label quetiapine use25% risks/benefits of treatment were documented as part of a patient discussion.25% had documented evidence that alternative treatment options were discussed.25% had documented evidence of Community consultant/GP consent/agreement was obtained before transfer of prescribing75% had a documented plan for review of quetiapine for treatment efficacy and side effects50% had a documented plan in place for ongoing physical health monitoringConclusionSuggested a wider audit may be required with greater patient numbers and which specifically filters for patients prescribed quetiapine.Audit result has been shared with Crisis team members, Medicines Optimisation Committee and South Locality Quality Standards Committee in the trust.

Tardive Dyskinesia: A Concern for the Pediatrician

PEDIATRICS ◽  
1986 ◽  
Vol 77 (4) ◽  
pp. 553-556
Author(s):  
HARVEY S. SINGER
Keyword(s):  
Side Effects ◽  
Tardive Dyskinesia ◽  
Children And Adolescents ◽  
Behavior Disorders ◽  
Antipsychotic Drugs ◽  
Extrapyramidal Side Effects ◽  
Body Movements ◽  
Neuroleptic Therapy

Antipsychotic drugs, such as the phenothiazines (chlorpromazine, fluphenazine, thioridazine), butyrophenones (haloperiodol), and diphenylbutylpiperidines (pimozide) are used in children and adolescents to treat a variety of clinical entities including psychoses, tics, behavior disorders, and movement problems. Because virtually all of these drugs have a potential to affect body movements and posture, they have also been termed neuroleptics.1 Most physicians are aware of the more common acute extrapyramidal side effects of these drugs, such as oculogyria, pseudoparkinsonism, dystonia, and restlessness (akathisia). Despite the widespread use of neuroleptics, however, little is known about the long-term neurologic consequences of such treatment. Of particular concern, based originally on data in adults, is the risk of severe and persistent tardive dyskinesia developing in persons receiving neuroleptic therapy.

Pharmacogenomics Genome Wise Association Clinical Studies

2015 ◽  
pp. 218-233
Author(s):  
Udayaraja GK
Keyword(s):  
Side Effects ◽  
Drug Toxicity ◽  
Dose Adjustment ◽  
Drug Efficacy ◽  
New Drugs ◽  
Genomic Research ◽  
Drug Doses ◽  
Genetic Makeup ◽  
Trial And Error Method ◽  
Error Method

Pharmacogenomics deals with drug responses in individual based on genetic variation in genome. Based on genetic variations, drugs may produce more or less therapeutic effect, and same way in side effects also. Physicians can use information about your genetic makeup to choose those drugs and drug doses to get better therapy. Optimizing drug therapy and rational dose adjustment with respect to genetic makeup will maximize drug efficacy and minimal adverse effects. This broken traditional ‘trial and error' method of ‘one drug fits all', and ‘one dose fits all' which contributing to 25–50% of drug toxicity or treatment failures. This will contribute to improve the ways in which existing drugs are used, genomic research will lead to drug development to produce new drugs that are highly effective without serious side effects. This approach to bring personalized medicine more practice and drug combinations are optimized for each individual' genetic makeup.

Therapeutic issues

2019 ◽  
pp. 993-1040
Author(s):  
David Semple ◽  
Roger Smyth
Keyword(s):  
Weight Gain ◽  
Medication Adherence ◽  
Side Effects ◽  
Sexual Dysfunction ◽  
Kidney Disease ◽  
Off Label ◽  
Negative Side ◽  
Negative Side Effects ◽  
Potential Interactions ◽  
In Pregnancy

This chapter covers therapeutic issues in psychiatry, from medication adherence, off-label prescribing and associated legal considerations, negative side effects such as weight gain and sexual dysfunction in different forms of psychiatric medicines, potential interactions or contraindications for prescribing, and specific side effects. Special prescribing cases, such as psychiatric medicine in pregnancy and breastfeeding patients or those with heart, liver, or kidney disease, are explained.

scholarly journals Use of fluoxetine in patients with diabetes mellitus

1995 ◽  
Vol 19 (9) ◽  
pp. 553-554
Author(s):  
Gill Salmon
Keyword(s):  
Diabetes Mellitus ◽  
At Risk ◽  
Side Effects ◽  
Pharmaceutical Companies ◽  
Important Group ◽  
Patients With Diabetes

Although pharmaceutical companies report side effects that may occur with use of their medications, little data on specific groups of patients that may be at risk of particular side effects is available (Katz et al, 1991). Patients with diabetes mellitus form an important group for psychiatrists since the occurrence of depression is relatively common with this group and guidance on its treatment is lacking.

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