Neuroleptic malignant syndrome (NMS) is a life threatening medical state complicating the use of antipsychotic medications and other drugs that affect the dopaminergic system on administration or withdrawal. The condition was recognised nearly half a century ago, shortly after the discovery of antipsychotic medications. However, there are still no systematic ...

Clinical evidence supporting the use of atypical antipsychotic medication (broad-spectrum psychotropic agents) in the treatment of depressive disorders is increasing rapidly. Animal models suggest that when atypical antipsychotic medications are used in combination with a selective serotonin reuptake inhibitor there is additional activation of frontal dopaminergic and noradrenergic neurotransmitter systems. ...

Comorbidity of substance abuse disorders (SUD) with bipolar disorders (BPD) is a serious treatment problem. Childhood BPD can be further complicated by comorbidity with attention-deficit/hyperactivity disorder (ADHD) and later SUD during adolescence. The aim of this article is to review the literature on pharmacotherapies for these patients. Developing the ideal ...

AIM: To demonstrate that hyperprolactinaemia and/or prolactinoma occur in association with antipsychotic medication use. METHODS: Three case studies of patients with markedly elevated serum prolactin level (>132 microg/l); either antipsychotic medication induced or as a consequence of a prolactinoma. CONCLUSION: The management and investigation of children with markedly elevated serum ...

Attention-deficit/hyperactivity disorder (ADHD) is the most common neuropsychiatric disorder of childhood. Recent research indicates that ADHD most often persists into adolescence and adulthood, and is associated with impairments in academic, social and occupational functioning. The ADHD diagnosis is based on history and clinical examination. There are no objective laboratory measures ...

OBJECTIVE: To evaluate the prevalence and severity of hyperprolactinemia among a large sample of patients with schizophrenia and related psychotic disorders treated with typical and atypical antipsychotic medications. METHOD: Three electronic databases (general medical, psychiatric, and pharmacologic) containing the census data from November 2002 through March 2003 for a state-funded, ...

BACKGROUND: The gene encoding catechol-O-methyltransferase (COMT), an enzyme that regulates prefrontal cortex dopamine, contains a common functional polymorphism (val(108/158)met) that influences prefrontal cortex function in an allelic dose-dependent manner. A recent study reported that the COMT val(108/158)met polymorphism influences cognitive- and physiologic-related prefrontal cortex responses to antipsychotic treatment. The present ...

PURPOSE OF REVIEW: Behavioral instability in children and adolescents is a vexing problem faced by many clinicians. This dilemma is magnified when it presents in a child with an acute medical condition. Effective treatment in these cases with medications may help to reduce morbidity and facilitate appropriate medical care for ...

Depression is a physiological disorder that is medically treated by increasing the bodily amount of one or all of the following neurotransmitters: serotonin, dopamine and norepinephrine. Although there are seven distinct classes of antidepressants, prehospital care professionals should at minimum be able to distinguish the monoamine oxidase inhibitors (MAOIs), tricyclic ...

This article provides an update of pediatric psychopharmacologic treatment evidence and focuses on six classes of medications in pediatric populations: psychostimulants, mood stabilizers, SSRIs, tricyclic antidepressants, antipsychotic agents, and other agents. The evidence is organized by disorder so that it is most useful to practicing clinicians. We begin each section ...

The pharmacotherapy of cocaine dependence is a rapidly developing field of research that may soon produce efficacious medications. Expanding research on reward-related brain circuitry, which is acutely activated and chronically dysregulated by cocaine, has helped reveal the neurobiological features of cocaine dependence and is guiding pharmacologic strategies that have significant ...

This study examined the impact of three program-level factors (coercion level, type of antipsychotic prescribed, and guardian supervision) on antipsychotic medication adherence among parolees mandated to an outpatient psychiatric clinic. Overall, 70.7% of the participants tested positive for their prescribed antipsychotic. Older patients were more likely to test positive for ...

RATIONALE: Current medications for attention-deficit/hyperactivity disorder (ADHD) include some single isomer compounds [dextroamphetamine (D: -amphetamine, dexedrine) and dexmethylphenidate (Focalin)] and some racemic compounds [methylphenidate and mixed-salts amphetamine (Adderall)]. Adderall, which contains approximately 25% L: -amphetamine, has been successfully marketed as a first-line medication for ADHD. Although different clinical effects have ...

OBJECTIVES: There exists a substantial and growing body of evidence suggesting that antipsychotic medications are efficacious in the treatment of many non-psychotic psychiatric disorders. Although indications for the use of antipsychotics (particularly the atypicals) remain relatively narrow in Australia, psychiatrists seem to be using them for an expanding range of ...

BACKGROUND: Recently amygdala enlargement has been reported in patients with schizophrenia like psychosis of epilepsy. The effect of antipsychotic medication on amygdala structure has not been investigated so far. There is theoretical evidence to support the assumption that dopaminergic neurotransmission might affect neuronal plasticity. METHODS: In order to analyze the ...

Psychosis in Parkinson's disease (PD) is a fairly common and vexing problem. Although it can occur at any stage of the illness, it is a particularly important issue for patients who are in the later stages of PD and have been chronically treated with anti-PD medications. The exact pathophysiology of ...

BACKGROUND: There is significant controversy surrounding attention deficit hyperactivity disorder (ADHD). While the existence of this disorder is generally accepted, debate continues in relation to aspects of assessment, as well as the effectiveness and choice of treatment options and their continuation into adult life. Management is further complicated as people ...

A majority of psychiatric medications are known to generate weight gain and ultimately obesity in some patients. There is much speculation about the prevalence of weight gain and the degree of weight gain during acute and longitudinal treatment, but consensus shows that weight gain is prominent. The present review looked ...

Deep brain stimulation (DBS) can relieve dyskinesias effectively and safely. This modality is applied most commonly in the treatment of dyskinesias associated with levodopa therapy for Parkinson disease. The subthalamic nucleus (STN) and globus pallidus internus (GPi) are the most common surgical targets. Deep brain stimulation of the GP has ...

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) and antiparkinsonian medication have proved to be effective treatments for tremor in Parkinson's disease. To date it is not known how and to what extent STN DBS alone and in combination with antiparkinsonian medication alters the pathophysiology of resting and postural ...

A brief review of the efficacy and common side effects of pharmacological treatments for attention-deficit/hyperactivity disorder (ADHD) is presented. Methylphenidate and amphetamine continue to have the strongest base of empiric support. They are both available in extended- and immediate-release preparations. Although most children with ADHD respond favorably to either medication, ...

By the year 2000, droperidol had become a standard drug for the treatment of behavioural emergencies in both psychiatric and medical settings. In 2001, the US FDA issued a 'black box' warning, citing cases of QT prolongation and/or torsades de pointes. As a result, the use of droperidol has been ...

The use of psychotropic medication with persons who have mental retardation was surveyed. Data were collected on a large sample of Oklahomans in both 1994 and 2000. Analysis revealed that the use of antidepressant medication increased dramatically over the course of the study, apparently as a function of increased use ...

OBJECTIVE: To determine whether acute neuroleptic-induced parkinsonism and akathisia were risk factors for the later development of tardive dyskinesia (TD) in patients on typical neuroleptics. METHOD: Of 100 subjects examined for parkinsonism and akathisia after the initiation of typical neuroleptic medication, 78 were followed up for TD after a mean ...

BACKGROUND: High rates of osteoporosis in schizophrenia may result from the prolactin-raising effects of some antipsychotic medication. Aims To examine bone mineral density in relation to relevant endocrine variables in patients with schizophrenia taking prolactin-raising antipsychotics. METHOD: Fifty-five patients who had been receiving prolactin-raising antipsychotic medication for >10 years underwent ...

Pharmacotherapy is the most common intervention for attention-deficit hyperactivity disorder (ADHD). Stimulant medications are highly efficacious and are the gold-standard for treating the inattention, impulsivity and excessive motoric activity associated with ADHD. Methylphenidate and amphetamine-based stimulants are now available in longer-acting, once-daily and shorter-acting divided dosing schedules. Several nonstimulant, second-line ...

PURPOSE: In the literature, noncompliance to medication in patients with schizophrenia ranges from 20 to 89%. There is an urgent need for reliable and valid techniques that measure compliance in antipsychotic drug treatment. In this study, we use pharmacy-dispensing records to assess compliance by calculating the refill rate of antipsychotic ...

There is a strong literature supporting a relationship between ADHD and SUD. Clearly, ADHD adolescents with conduct or bipolar disorder as partof their clinical picture are at the highest risk for SUD. ADHD without comorbidity appears to confer an intermediate risk factor for SUD that appears to manifest in young ...

BACKGROUND: Non-compliance with antipsychotic medication is known to be one of the major reasons for relapse in patients with schizophrenia. Carers might be able to reduce noncompliance by enhancing the patient's knowledge about the illness and antipsychotic medication and by carrying out regular benefit/risk discussions concerning the treatment plan, thereby ...

A majority of psychiatric medications are known to generate weight gain and ultimately obesity in some patients. There is much speculation about the prevalence of weight gain and the degree of weight gain during acute and longitudinal treatment with these agents. There is newer literature looking at the aetiology of ...

BACKGROUND: The pharmacological treatment of bipolar disorder has dramatically improved with multiple classes of agents being used as mood-stabilizers, including lithium, anticonvulsants, and atypical antipsychotics. However, the use of these medications is not without risk, particularly when a patient with bipolar disorder also has comorbid medical illness. As the physician ...

BACKGROUND: Shortly after phenothiazines were introduced, they were found to elevate serum triglyceride and total cholesterol levels. During the past decade, an increasing body of literature has also documented this effect in atypical antipsychotics. Previous studies of antipsychotic-associated hyperlipidemias are based on clinical samples, mostly from case series. We studied ...

OBJECTIVE: In the Multimodal Treatment Study of ADHD (MTA), the effects of medication management (MedMgt) and behavior modification therapy (Beh) and their combination (Comb) and usual community comparison (CC) in the treatment of attention-deficit/hyperactivity disorder (ADHD) differed at the 14-month assessment as a result of superiority of the MTA MedMgt ...

Despite the plethora of evidence that demonstrates the efficacy of novel antipsychotic medications, there are mounting concerns about their side effects. Major concerns are data that link some agents with metabolic effects, such as obesity, type 2 diabetes, and CVD. For these reasons, patients receiving novel antipsychotic medications must be ...

BACKGROUND: Schizophrenia shortens life, e.g. through suicide and obesity-related diseases such as type 2 diabetes mellitus. It is assumed that medications play a major role, but most of the evidence for this comes from studies poorly controlled for variables such as lifestyle and medication status. AIMS: To determine whether schizophrenia ...

BACKGROUND: Most evidence suggesting an association between schizophrenia, antipsychotic medications and diabetes has been based on retrospective studies not controlled for important confounders. AIMS: To compare diabetogenic risk between antipsychotic medications; and to describe the limitations of current prospective data-sets. METHOD: Systematic review of prospective clinical data. RESULTS: No difference ...

BACKGROUND: The Texas Medication Algorithm Project (TMAP) has been a public-academic collaboration in which guidelines for medication treatment of schizophrenia, bipolar disorder, and major depressive disorder were used in selected public outpatient clinics in Texas. Subsequently, these algorithms were implemented throughout Texas and are being used in other states. Guidelines ...

Improved compliance with pharmacotherapy was achieved in treating Hispanic outpatients with psychotic disorders when recognition of culturally based differences between patients and psychiatrists led to modifications in prescribing practices. Unacculturated Hispanic outpatients experienced akathisia as an increase in "nerviosismo." Addressing this issue, as well as using anxiolytics and low doses ...

Antipsychotic medication is integral to the treatment of severe and enduring mental health problems (e.g. schizophrenia). Such medication is associated with significant adverse side effects that can affect treatment adherence. To date there have been few attempts to analyse qualitatively service users' experience of taking antipsychotic medication. This study, conducted ...

Previous cross-sectional studies on covert orienting of visual attention in schizophrenia have been inconsistent. In the present longitudinal study, we examined 40 medicated acutely ill inpatients with a covert orienting of attention task (COVAT) shortly after admission, and again 12-16 weeks after the initial examination, while most patients were in ...

OBJECTIVE: The purpose of this study was to examine the efficacy of psychostimulant medication in a naturalistic sample of preschoolers. Benefits and side effects for methylphenidate and mixed amphetamine salts (Adderall) were examined. METHOD: Twenty-eight preschoolers (ages 4.0 - 5.9) participated in the present investigation. They were obtained consecutively from ...

We describe the case of a 12-year-old white male in whom significant weight gain occurred within 3 months of treatment with Ziprasidone. It is important that clinicians are aware of this possibility since this medication is marketed as one of the few antipsychotic medications not associated with significant weight gain.

OBJECTIVE: To selectively review the literature on obesity in people with schizophrenia. CONCLUSIONS: Obesity is a common problem for people with schizophrenia, with an estimated 40-60% of this population being obese or overweight. Obesity among the mentally ill may contribute to adverse medical and psychological consequences as well as medication ...

BACKGROUND AND PURPOSE: While there have been anecdotal observations of binge eating in childhood-onset narcolepsy, the possible relationship between increased weight gain and childhood-onset narcolepsy has not been evaluated. PATIENTS AND METHODS: A retrospective, case-control design was used to compare the body mass index (BMI) of 31 narcolepsy children at ...

Atypical antipsychotics are less likely to cause hyperprolactinemia-related side effects, such as infertility; hence it is predicted that more women taking antipsychotic medications will be able to become pregnant as the use of atypical antipsychotics increases. To compare the use of conventional and atypical antipsychotics, we conducted a retrospective review ...

This paper reports on a qualitative, critical study into the lives of relatives and partners of people living with enduring effects of schizophrenia. A review of the literature showed that caregivers and relatives of sufferers were seldom asked about their experiences, instead they were subject to blame or criticism regarding ...

OBJECTIVE: The purpose of this investigation was to evaluate the effects of clozapine and risperidone on social skill and problem solving in patients with schizophrenia. METHOD: The Wisconsin Card Sorting Test and the Maryland Assessment of Social Competence were administered at baseline, week 17, and week 29 of a multisite ...

For clients who receive medical treatment for a severe and enduring mental health problem, antipsychotic medication is the first line of treatment. The adverse effects of these medications are well documented and can lead to discontinuation of therapy. The newer atypical antipsychotics would seem to have distinct advantages over more ...

Few studies have examined gender differences in the propensity to gain weight on clozapine. Weight gain increases risk for many medical illnesses and is of particular concern for people with schizophrenia who are more overweight than the general population. Long-stay patients in Connecticut state hospitals were randomly assigned to switch ...

The contribution of cerebellar brain circuits to schizophrenia has been previously alluded to in the literature. This study examines current reappraisals of cerebellar involvement in cognition and behavior. An individual with documented developmental cerebellar anomalies who developed schizophrenic symptoms in late adolescence is described. Psychiatric, medical, and cognitive assessments were ...