scholarly journals Anti-stress Properties of Atypical Antipsychotics

2020 ◽  
Vol 13 (10) ◽  
pp. 322
Author(s):  
Alice Sanson ◽  
Marco A. Riva

Stress exposure represents a major environmental risk factor for schizophrenia and other psychiatric disorders, as it plays a pivotal role in the etiology as well as in the manifestation of disease symptomatology. It may be inferred that pharmacological treatments must be able to modulate the behavioral, functional, and molecular alterations produced by stress exposure to achieve significant clinical outcomes. This review aims at examining existing clinical and preclinical evidence that supports the ability of atypical antipsychotic drugs (AAPDs) to modulate stress-related alterations. Indeed, while the pharmacodynamic differences between AAPDs have been extensively characterized, less is known on their ability to regulate downstream mechanisms that are critical for functional recovery and patient stabilization. We will discuss stress-related mechanisms, spanning from neuroendocrine function to inflammation and neuronal plasticity, which are relevant for the manifestation of schizophrenic symptomatology, and we will discuss if and how AAPDs may interfere with such mechanisms. Considering the impact of stress in everyday life, we believe that a better understanding of the potential effects of AAPDs on stress-related mechanisms may provide novel and important insights for improving therapeutic strategies aimed at promoting coping mechanisms and enhancing the quality of life of patients affected by psychiatric disorders.

CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 207-208 ◽  
Author(s):  
Oscar Patterson-Lomba ◽  
Rajeev Ayyagari ◽  
Benjamin Carroll

AbstractBackgroundTardive dyskinesia (TD) is typically caused by exposure to antipsychotics, is often irreversible, and can be debilitating. TD symptoms can increase the social stigma of patients with comorbid psychiatric disorders, negatively impact quality of life, and potentially increase medical morbidity and mortality. An increased risk of developing TD has been associated with factors such as older age, female sex, underlying mental illness, and long-term use and higher doses of antipsychotics. The association of TD with the use of typical versus atypical antipsychotics has also been evaluated, with mixed results. To date, predictive models assessing the joint effect of clinical characteristics on TD risk have not been developed and validated in the US population.Study ObjectiveTo develop a prediction model to identify patient and treatment characteristics associated with the occurrence of TD among patients with psychiatric disorders taking antipsychotic medications, using a retrospective database analysis.MethodsAdult patients with schizophrenia, major depressive disorder, or bipolar disorder who were taking oral antipsychotics, and who had 6months of data prior to the index date were identified from Medicaid claims from six US states. The index date was defined as the date of the first claim for an antipsychotic drug after a claim for the underlying disorder but before TD diagnosis. A multivariate Cox prediction model was developed using a cross-validated version of the least absolute shrinkage and selection operator (LASSO) regression method to improve prediction accuracy and interpretability of the model. The predictive performance was assessed in a separate validation set via model discrimination (concordance) and calibration.ResultsA total of 189,415 patients were identified: 66,723 with bipolar disorder, 68,573 with depressive disorder, and 54,119 with schizophrenia. The selected prediction model had a clinically meaningful concordance of 70% and was well calibrated (P=0.46 for Hosmer–Leme show goodness-of-fit test). Patient’s age at index date (hazard ratio [HR]: 1.03), diagnosis of schizophrenia (HR: 1.73), dosage of antipsychotic at index date (up to 100mg/day chlorpromazine equivalent; HR: 1.40), and presence of bipolar and related disorders (HR: 1.16) were significantly associated with an increased risk of TD diagnosis. Use of atypical antipsychotics at index date was associated with a modest reduction in the risk of TD (HR=0.94).ConclusionsThis study identified a group of factors associated with the development of TD among patients with psychiatric disorders treated with antipsychotics. This may allow physicians to better monitor their patients receiving antipsychotics, allowing for the prompt identification and treatment of TD to help maintain quality of life.Presented at: American Psychiatric Association Annual Meeting; May 5–9, 2018, New York, New York, USAFunding Acknowledgements: This study was supported by Teva Pharmaceuticals, Petach Tikva, Israel.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wen Li ◽  
Na Zhao ◽  
Xiaona Yan ◽  
Siyun Zou ◽  
Huan Wang ◽  
...  

AbstractThe impact of the COVID-19 pandemic on clinically stable older patients with psychiatric disorders is unclear. This study examined the prevalence of depressive and anxiety symptoms, and their associations with quality of life (QOL) in clinically stable older patients with psychiatric disorders during the COVID-19 pandemic. This was a multicenter, cross-sectional study. Depressive and anxiety symptoms, insomnia, pain, and QOL were assessed with standardized instruments. A total of 1063 patients were included. The prevalence of depressive and anxiety symptoms, and combined depressive and anxiety symptoms were 62.3% (95%CI = 59.4–65.2%), 52.4% (95%CI = 49.3–55.4%), and 45.9% (95%CI = 42.9–48.9%), respectively. Patients with depressive and anxiety symptoms had significantly lower QOL than those without (P < 0.01). Binary logistic regression analyses revealed that having depressive symptoms was positively associated with more severe insomnia (OR = 1.29, P < 0.01) and pain (OR = 1.14, P < 0.01), and was negatively associated with other psychiatric diagnoses (except for major depressive disorder, schizophrenia, and organic mental disorder; OR = 0.50, P < 0.01), while having anxiety symptoms was positively associated with severe physical diseases (OR = 1.57, P = 0.02), poor adherence to treatment (OR = 1.50, P < 0.01), and more severe insomnia (OR = 1.15, P < 0.01) and pain (OR = 1.11, P < 0.01). Having combined depression and anxiety symptoms was positively associated with poor adherence to treatment (OR = 1.42, P = 0.02) and more severe insomnia (OR = 1.19, P < 0.01) and pain (OR = 1.15, P < 0.01), and was negatively associated with the diagnosis of schizophrenia (OR = 0.50, P = 0.04) and others (OR = 0.53, P < 0.01). Depressive and anxiety symptoms were common in clinically stable older patients with psychiatric disorders during the COVID-19 pandemic. Considering the negative impact of these symptoms on QOL, regular screening and appropriate treatment are recommended for this population.


2015 ◽  
Vol 28 (4) ◽  
pp. 273-277
Author(s):  
Milena Korczak ◽  
Jacek Owczarek

Abstract The article is the result of research on the impact of non-pharmacological therapies for diseases of the locomotor system on the prescribed drug use and lifestyles of the patients of the sanatoria in Busko-Zdroj. The reported research uses primary and secondary measures. The former includes the assessment of the impact of non-pharmacological sanatorium treatments for locomotor system diseases on the use of prescribed drug regimes, while the latter is aimed at assessing the patients’ quality of life. The research was conducted on adult patients of both genders in the sanatoria in Busko-Zdroj. The subjects were patients suffering from disorders of the musculoskeletal system such as rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, osteoporosis and discopathies. The research included two visits, the first at the start of the research and the second at the end of the research. The patients were examined for a period of three consecutive weeks. The study involved 170 patients, 50% of them were women and 50% men. A decline in the use of painkillers and anti-inflammatory drugs makes a very interesting finding. After the first week, as many as 38% of the examined patients limited the use of painkillers and/or anti-inflammatory drugs. After the second week, 62% of the patients reduced the use of the drugs, and after the third week of treatment, up to 90% of the patients did so. The improvement of patients’ lives is noticeable in the psychological, physical and motor fields.


Author(s):  
Jonas Kuon ◽  
Miriam Blasi ◽  
Laura Unsöld ◽  
Jeannette Vogt ◽  
Anja Mehnert ◽  
...  

Abstract Purpose The purpose of this study is to investigate changes over time in quality of life (QoL) in incurable lung cancer patients and the impact of determinants like molecular alterations (MA). Methods In a prospective, longitudinal, multicentric study, we assessed QoL, symptom burden, psychological distress, unmet needs, and prognostic understanding of patients diagnosed with incurable lung cancer at the time of the diagnosis (T0) and after 3 (T1), 6 (T2) and 12 months (T3) using validated questionnaires like FACT-L, National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT), PHQ-4, SCNS-SF-34, and SEIQoL. Results Two hundred seventeen patients were enrolled, 22 (10%) with reported MA. QoL scores improved over time, with a significant trend for DT, PHQ-4, and SCNS-SF-34. Significant determinants for stable or improving scores over time were survival > 6 months, performance status at the time of diagnosis, and presence of MA. Patients with MA showed better QoL scores (FACT-L at T1 104.4 vs 86.3; at T2 107.5 vs 90.0; at T3 100.9 vs 92.8) and lower psychological distress (NCCN DT at T1 3.3 vs 5; at T2 2.7 vs 4.5; at T3 3.7 vs 4.5; PHQ-4 at T1 2.3 vs 4.1; at T2 1.7 vs 3.6; at T3 2.2 vs 3.6), but also a worsening of the scores at 1 year and a higher percentage of inaccurate prognostic understanding (27 vs 17%) compared to patients without MA. Conclusion Patients with tumors harboring MA are at risk of QoL deterioration during the course of the disease. Physicians should adapt their communication strategies in order to maintain or improve QoL.


Author(s):  
Claire Y. J. Wenham ◽  
Philip G. Conaghan

Osteoarthritis (OA) is a common condition which often causes pain and functional limitation, significantly impacting on a person's quality of life. A comprehensive assessment of the impact of OA should be performed before selecting therapies and treatment goals. Current recommended therapies include a combination of pharmacological and non-pharmacological therapies, which should be considered for all people with OA, regardless of anatomical site of involvement. Non-pharmacological treatments include education, muscle strengthening and aerobic exercises, weight loss if appropriate, splints and devices, and aids. Pharmacological therapies include paracetamol, oral and topical non-steroidal anti-inflammatory drugs, topical capsaicin, intra-articular corticosteroid injections, and opioids. Many existing therapies have only a small analgesic effect size and, in the case of drug therapies, may be associated with important side effects, so an individual's symptoms and comorbidities must be taken into account when selecting therapies. For those who do not respond to these treatments, surgery such as a total joint arthroplasty may be required. There is a strong need for new analgesic treatments for OA. As it is becoming increasingly clear that the sources of pain in OA are complex and multifactorial, future treatments for OA will need to target both peripheral and central pain mechanisms.


2015 ◽  
Vol 24 (2) ◽  
pp. 159-164 ◽  
Author(s):  
Mihaela Fadgyas Stanculete ◽  
Silviu Matu ◽  
Cristina Pojoga ◽  
Dan L. Dumitrascu

Background & Aims: Irritable bowel syndrome (IBS) is a chronic and disabling gastrointestinal disorder. Although considerable research has underlined the influence of coping mechanisms as the determinants of the quality of life (QOL), only limited data are available regarding the specific coping mechanisms used by IBS patients to manage illness in daily life. Irrational cognitions are known to emerge in stressful situations such as chronic diseases, and it has been proposed to have implications in the QOL. The aim of this study was to explore the relationship between coping styles and irrational beliefs in predicting the effects of IBS symptoms on the health-related QOL (HRQOL).Methods: A cross-sectional study was performed at two tertiary gastroenterology centers. A sample of 70 consecutive IBS patients and 55 healthy controls was studied. All participants completed the Brief Cope Inventory, the Dysfunctional Attitudes Scale, the Short-Form Health Survey and a demographic questionnaire.Results: All the HRQOL scores of the group with IBS were significantly lower than the HRQOL scores of the healthy group [Pillai's trace V = 0.404, F(8, 116) = 9.833, p < 0.001]. Irritable bowel syndrome patients used more problem-focused coping and avoidant-oriented coping than healthy subjects. The impact of IBS symptoms on HRQOL distress is mediated by irrational beliefs and avoidant oriented coping.Conclusions: Our findings highlight the role of irrational cognition and coping mechanisms in patients with IBS. The results underline the importance of the evaluation of psychological aspects of IBS with the possibility of having more tailored treatments for these patients.


2013 ◽  
Vol 8 ((Suppl.1)) ◽  
pp. 2 ◽  
Author(s):  
Gavin Giovannoni ◽  
John F Fole ◽  
David W Brandes ◽  
◽  
◽  
...  

Multiple sclerosis (MS) is a heterogeneous condition that presents with a large variety of symptoms. While motor functions including coordination, gait and walking ability are clearly visible to clinicians, including MS specialists. These are sometimes termed hidden disabilities and are often overlooked because patients do not mention them in consultations, either because they are embarrassed, do not want to disappoint their family and therefore do not mention the symptoms, or they have not linked the symptoms to their disease. Hidden disabilities in MS include cognition and memory impairment, depression, anxiety and pseudobulbar affect, pain, fatigue, sleep disorders, bowel, bladder and sexual dysfunctions, osteopenia and osteoporosis. These disabilities are associated with a reduced quality of life in patients, their families and caregivers, and affect the ability of patients to function in everyday life. Pharmacological treatments and other interventions are available to manage these symptoms; however, the effectiveness of these interventions in MS is variable. There is need for greater recognition and further research into therapeutic options to reduce the burden of hidden disabilities in MS.


2016 ◽  
Vol 33 (S1) ◽  
pp. S561-S561
Author(s):  
M. Silva ◽  
A.R. Figueiredo ◽  
A. Fornelos ◽  
P. Macedo ◽  
S. Nunes

IntroductionTinnitus is defined as the subjective or objective perception of a hearing sensation in the absence of a corresponding external stimulus. It is a very common medical symptom, and some studies show that 5 to 15% of adults had tinnitus in life. It is a condition that could be chronic and for some patients could be very debilitating. Anxiety and depression are common findings in patients with tinnitus. Tinnitus can also interfere with sleep and concentration and affect the quality of life of patients. The heterogeneity of the etiology, pathophysiology and clinical features of tinnitus probably exacerbate the variability of response to treatment of the population and the decision on the best treatment option could be complex.ObjectivesThe purpose of this study is try to understand how the psychotherapeutic interventions may be useful in the treatment of tinnitus.MethodsBibliographic research in Pubmed.ResultsCurrently there are no available effective pharmacological treatments. In some cases, surgical interventions may be effective with respect to ear pathology, but not to tinnitus. Most studies show that psychological interventions are needed to reduce the distress and the impact caused by tinnitus in patients’ lives and the cognitive-behavioral therapy is the primary therapeutic intervention in chronic tinnitus.ConclusionAlthough cognitive-behavioral techniques demonstrated to be effective in the treatment of the distress and impact caused by tinnitus, little is known about the mechanisms by which this technique achieves this effect, therefore most authors suggest that further studies should be conducted in this area.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 190-190
Author(s):  
Catherine Garcia ◽  
Alexis Reeves ◽  
John Pamplin ◽  
Uchechi Mitchell ◽  
Lauren Brown

Abstract While evidence highlights the detrimental health consequences of stress exposure for Black Americans, the impact of stress exposure on health varies by the stressor, individual appraisal and coping mechanisms examined. In this study, we aim to explore the differential effects of chronic stress exposure by means of latent class analysis on mental and physical health. Data come from 800 Black older adults ages 52+ from the 2006 Health and Retirement Study. A set of items that include stress exposure, appraisal and coping were used to assess chronic stress burden on anxiety, depressive symptoms and chronic conditions to identify stress and health clusters. Analysis revealed four subgroups, each demonstrated a typological response pattern with the most pronounced health consequences for high stress exposure, appraisal and few or no coping mechanisms. Results show an alternative approach to examining the stress-health link by using a combined person- and variable-centered approach.


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