Schizophrenia

Research Update

New Combination Treatment Mitigates Antipsychotic-Induced Weight Gain

Topics: Metabolic syndrome | olanzapine | Opioid antagonist | Samidorphan | Schizophrenia | Weight gain

Review of: Correll CU et al, Am J Psychiatry 2020;177(12):1168–1178 To date, we have had no FDA-approved medications to mitigate antipsychotic-­associated weight gain (AIWG). This will soon change, thanks to recent research showing that samidorphan, an opioid receptor antagonist, appears to significantly lessen weight gain associated with the use

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Expert Q&A

Combination Treatment for Schizophrenia

Topics: Adjunct treatment | Antidepressant | Antipsychotic | Benzodiazepine | CATIE | Combination treatment | Free Articles | Mood stabilizer | Outcomes | Psychopharmacology | Schizoaffective disorder | Schizophrenia | Substance Use Disorder

CHPR: You recently published a study on the use of adjunctive medications in patients with schizophrenia (Stroup TS et al, JAMA Psychiatry 2019;76(5):508–515). Your findings were provocative as you found that adjunctive medications often help improve patients’ outcomes, yet many clinicians avoid polypharmacy because of concern that patients will exp

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Clinical Update

A Potentially Lethal Side Effect You Probably Never Heard Of

Topics: Clozapine | FDA Warnings | Free Articles | Management | Psychosis | Schizophrenia

In January 2020, the FDA issued a strong warning about constipation on clozapine. With a fatality rate of 1 in 1000, this is not just a nuisance side effect, and it can happen with other antipsychotics and psychotropics as well. This type of constipation is caused by slowing of the gut, or gastric hypomotility, and it requires a unique approach. Fiber s

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Expert Q&A

The Schizophrenia-OCD Overlap

Topics: Antipsychotics | Aripiprazole | Clozapine | Comorbidity | Diagnosis | Lamictal | Lamotrigine | Obsessive Compulsive Disorder | OCD | olanzapine | Pharmacology Tips | polypharmacy | Quetiapine | Risperidone | Schizoaffective disorder | Schizophrenia

TCPR: What is schizo-obsessive disorder?Dr. Poyurovsky: Schizo-obsessive disorder (schizo-OCD) is not a DSM diagnosis. The term is used to refer to patients with schizophrenic disorders that have comorbid features of OCD. We see these obsessive-compulsive symptoms in schizophrenia more often than would be expected by chance. About one in four patients h

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Research Update

Are SSRIs Associated With Increased Rates of Violence?

Topics: Deprescribing | Mania on Antidepressants | Medication adherence | polypharmacy | Psychosis | Psychotic Depression | Schizophrenia | Tags | Tardive dyskinesia | Withdrawal

REVIEW OF: Lagerberg et al, Eur Neuropsychopharm 2020;26:1–9 TYPE OF STUDY: Analysis of Swedish national registries Soon after the introduction of SSRIs in 1988, case reports began to emerge suggesting that they might trigger violence in a small subset of patients. At the time, such reports were mostly dismissed and attributed to the fact that p

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Research Update

How to Switch Antipsychotics

Topics: Antipsychotics | Deprescribing | Pharmacology | Pharmacology Tips | Psychopharmacology | Psychopharmacology Tips | Psychosis | Research Update | Schizophrenia

Review of: Takeuchi H and Remington G, J Psychopharmacol 2020;34(8):914–919 Type of study: Meta-analysis of randomized controlled trials Antipsychotic switching is a routine part of schizophrenia care, but what’s the best way to go from one medication to another? This article compared three strategies: 1) abruptly stopping the old antipsychotic an

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Clinical Update

How to Choose an Antipsychotic in Schizophrenia

Topics: Antipsychotics | Aripiprazole | Cariprazine | Clozapine | Negative Symptoms | olanzapine | Psychopharmacology | Psychopharmacology Tips | Psychosis | Risperidone | Schizophrenia

It’s been over a decade since the CATIE trial changed the way we look at antipsychotic drugs. Since then, the number of second-generation antipsychotics has about doubled, and the number of clinical trials has risen even more. Antipsychotics are not all the same, though, and when it comes to schizophrenia, a few stand out in ways that can help you fin

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Research Update

Polypharmacy in Schizophrenia

Topics: Research Updates | Schizophrenia

REVIEW OF: Tiihonen J et al, JAMA Psychiatry 2019;76(5):499–507 and Stroup T et al, JAMA Psychiatry 2019;76(5):508–515 TYPE OF STUDY: Retrospective non-randomized controlled trials Antipsychotic polypharmacy is discouraged in guidelines but common in practice. Up to 30% of patients with schizophrenia are prescribed multiple antipsychotics, and com

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Highlights

Highlights From This Issue

Topics: ADHD | Adult ADHD | Micronutrients | Narcolepsy | Schizophrenia

Micronutrients are vitamins and minerals that play an essential role in human physiology. They have promising studies in a host of psychiatric disorders, and Dr. Rucklidge explains why. Adult-onset ADHD has been proposed as a new diagnosis, but the data supporting it point in a different direction. Light therapy is one of few natural treatments with

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Article

Evaluating the Mortality Risks of Antipsychotics in Children and Youths

Topics: Antipsychotics | Psychopharmacology | Schizophrenia

There are reports of increased mortality from antipsychotics in older adults. Now, we have a paper showing increased mortality in children, adolescents, and young adults aged 5–24 years. Given the frequent use, both on- and off-label, of antipsychotics, does this change how we use them? And if so, how? What we already know In 2005, the FDA added a

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Research Update

Cannabidiol for Schizophrenia

Topics: Cannabidiol | Research Update | Schizophrenia

Review of: McGuire P et al, Am J Psychiatry 2017;175(315). doi:10.1176/appi.ajp.2017.17030325 Type of study: Double-blind, randomized controlled trial Traditional antipsychotic medications leave much to be desired. Their therapeutic response rate for schizophrenia is low, and their side effects are troubling and lead to high rates of noncompliance

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