scholarly journals Genetic Testing for Antipsychotic Pharmacotherapy: Bench to Bedside

2021 ◽  
Vol 11 (7) ◽  
pp. 97
Author(s):  
Mujeeb U. Shad
Keyword(s):  
Genetic Testing ◽  
Adverse Effects ◽  
Genetic Basis ◽  
Primary Objective ◽  
Psychotropic Medications ◽  
High Dose ◽  
Genetic Studies ◽  
Vulnerable Patients ◽  
Utility Of Information ◽  
Treatment Refractory

There is growing research interest in learning the genetic basis of response and adverse effects with psychotropic medications, including antipsychotic drugs. However, the clinical utility of information from genetic studies is compromised by their controversial results, primarily due to relatively small effect and sample sizes. Clinical, demographic, and environmental differences in patient cohorts further explain the lack of consistent results from these genetic studies. Furthermore, the availability of psychopharmacological expertise in interpreting clinically meaningful results from genetic assays has been a challenge, one that often results in suboptimal use of genetic testing in clinical practice. These limitations explain the difficulties in the translation of psychopharmacological research in pharmacogenetics and pharmacogenomics from bench to bedside to manage increasingly treatment-refractory psychiatric disorders, especially schizophrenia. Although these shortcomings question the utility of genetic testing in the general population, the commercially available genetic assays are being increasingly utilized to optimize the effectiveness of psychotropic medications in the treatment-refractory patient population, including schizophrenia. In this context, patients with treatment-refractory schizophrenia are among of the most vulnerable patients to be exposed to the debilitating adverse effects from often irrational and high-dose antipsychotic polypharmacy without clinically meaningful benefits. The primary objective of this comprehensive review is to analyze and interpret replicated findings from the genetic studies to identify specific genetic biomarkers that could be utilized to enhance antipsychotic efficacy and tolerability in the treatment-refractory schizophrenia population.

scholarly journals Thyroid Functions and Bipolar Affective Disorder

2011 ◽  
Vol 2011 ◽  
pp. 1-13 ◽  
Author(s):  
Subho Chakrabarti
Keyword(s):  
Bipolar Disorder ◽  
Affective Disorder ◽  
Clinical Course ◽  
Lithium Treatment ◽  
Bipolar Affective Disorder ◽  
High Dose ◽  
Careful Monitoring ◽  
Genetic Studies ◽  
Treatment Refractory ◽  
Hpt Axis

Accumulating evidence suggests that hypothalamo-pituitary-thyroid (HPT) axis dysfunction is relevant to the pathophysiology and clinical course of bipolar affective disorder. Hypothyroidism, either overt or more commonly subclinical, appears to the commonest abnormality found in bipolar disorder. The prevalence of thyroid dysfunction is also likely to be greater among patients with rapid cycling and other refractory forms of the disorder. Lithium-treatment has potent antithyroid effects and can induce hypothyroidism or exacerbate a preexisting hypothyroid state. Even minor perturbations of the HPT axis may affect the outcome of bipolar disorder, necessitating careful monitoring of thyroid functions of patients on treatment. Supplementation with high dose thyroxine can be considered in some patients with treatment-refractory bipolar disorder. Neurotransmitter, neuroimaging, and genetic studies have begun to provide clues, which could lead to an improved understanding of the thyroid-bipolar disorder connection, and more optimal ways of managing this potentially disabling condition.

Adverse Effects and Laboratory Parameters of High-Dose Olanzapine vs. Clozapine in Treatment-Resistant Schizophrenia

2003 ◽  
Vol 15 (3) ◽  
pp. 181-186 ◽  
Author(s):  
Deanna Kelly ◽  
Robert Conley ◽  
Charles Richardson ◽  
Carol Tamminga ◽  
William Carpenter
Keyword(s):  
Adverse Effects ◽  
High Dose ◽  
Treatment Resistant ◽  
Laboratory Parameters

T04-O-05 High dose Testosterone (T) treatment has no adverse effects on the endometrium of Female to Male transsexuals (FtM)

Sexologies ◽  
2008 ◽  
Vol 17 ◽  
pp. S78-S79 ◽  
Author(s):  
A.M. Perrone ◽  
F. Armillotta ◽  
G. Formelli ◽  
P. Casadio ◽  
N.C.M. Salfi ◽  
...  
Keyword(s):  
Adverse Effects ◽  
High Dose

scholarly journals Genetic Basis of Male Infertility

2013 ◽  
Vol 4 (1) ◽  
pp. 37-39 ◽  
Author(s):  
Mosammat Rashida Begum ◽  
Mariya Ehsan
Keyword(s):  
Genetic Testing ◽  
Male Infertility ◽  
Medical Treatment ◽  
Intracytoplasmic Sperm Injection ◽  
Chromosomal Abnormality ◽  
Genetic Disease ◽  
Genetic Basis ◽  
Common Cause ◽  
Near Future ◽  
Spermatogenic Failure

Infertility is a couple's problem. Almost 50% case males are responsible for infertility. Most common cause is oligospermia and azoospermia and approximately 5% to 15% of men with azoospermia and severe oligospermia may have a chromosomal abnormality. Men with significant spermatogenic compromise are the candidates of intracytoplasmic sperm injection (ICSI). Raised FSH level above 9 is an indication of spermatogenic compromise. So, medical treatment for these patients is waste of time and money. Early attempt of assisted reproduction is ideal to avoid the crisis of total spermatogenic failure in near future. But before going for ICSI genetic testing if possible and proper counseling about possibilities of transmission of genetic disease to offspring is necessary. DOI: http://dx.doi.org/10.3329/akmmcj.v4i1.13683 AKMMC J 2013: 4(1): 37-39  

scholarly journals Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomy

2017 ◽  
Vol 135 (3) ◽  
pp. 247-252 ◽  
Author(s):  
Luis Antônio Borges ◽  
Plínio da Cunha Leal ◽  
Ed Carlos Rey Moura ◽  
Rioko Kimiko Sakata
Keyword(s):  
Adverse Effects ◽  
Pain Intensity ◽  
Hospital Discharge ◽  
Primary Objective ◽  
Spinal Block ◽  
Early Recovery ◽  
Local Infiltration ◽  
Randomized Clinical Study ◽  
American Society ◽  
American Society Of Anesthesiologists

ABSTRACT BACKGROUND AND OBJECTIVES: Postoperative analgesia and early recovery are important for hospital discharge. The primary objective of this study was to compare the analgesic effectiveness of perianal infiltration and subarachnoid anesthesia for hemorrhoidectomy. The secondary objective was to compare time to discharge, adverse effects and complications. DESIGN AND SETTING: Randomized, prospective and comparative study at Dr. Mário Gatti Hospital. METHODS: Forty patients aged 18-60, in American Society of Anesthesiologists physical status category 1 or 2, were included. The local group (LG) received local infiltration (0.75% ropivacaine) under general anesthesia; the spinal group (SG) received subarachnoid block (2 ml of 0.5% bupivacaine). Analgesic supplementation consisted of fentanyl for LG and lidocaine for SG. Postoperative pain intensity, sphincter relaxation, lower-limb strength, time to discharge, analgesic dose over one week and adverse effects were assessed. RESULTS: Eleven LG patients (52.4%) required supplementation, but no SG patients. Pain intensity was higher for LG up to 120 min, but there were no differences at 150 or 180 min. There were no differences in the need for paracetamol or tramadol. Times to first analgesic supplementation and hospital discharge were longer for SG. The adverse effects were nausea, dizziness and urinary retention. CONCLUSIONS: Pain intensity was higher in LG than in SG over the first 2 h, but without differences after 150 and 180 min. Time to first supplementation was shorter in LG. There were no differences in doses of paracetamol and tramadol, or in adverse effects. REGISTRATION: ClinicalTrials.gov NCT02839538.

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