Medication use is a common cause of hyperprolactinemia, and it is important to differentiate this cause from pathologic causes, such as prolactinomas. To ascertain the frequency of this clinical problem and to develop treatment guidelines, the medical literature was searched by using PubMed and the reference lists of other articles ...

Clozapine is the most effective antipsychotic medication currently in use, but there has been a paucity of well-controlled research on its efficacy with people with developmental disabilities. We present a set of guidelines to ensure proper utilization of clozapine in individuals with developmental disabilities, because it can offer them therapeutic ...

Medications for attention deficit hyperactivity disorder (ADHD) currently represent the ninth largest segment of the CNS market by sales, with 2.4 billion USD spent annually on this condition and 40% annual growth. Stimulant medications remain the most effective ADHD therapies and provide robust improvement in ADHD symptoms in both youth ...

BACKGROUND: Antipsychotics drugs are known to cause sexual dysfunction and are said to be a major cause of non-compliance/poor compliance. There is no local data on the subject although clinical observations indicate that sexual dysfunction in patients on neuroleptics is relatively common. This study was carried out to ascertain the ...

BACKGROUND: Satisfaction with antipsychotic medication is an important outcome variable. To date, there is a lack of a well-established measure to quantify patient satisfaction with psychiatric medication. This paper describes the development, dimensionality, reliability and validity of the Satisfaction with Antipsychotic Medication (SWAM) scale. METHOD: Clinical and academic experts devised ...

Use of concomitant medications with antipsychotic agents in the treatment of schizophrenia is common but lacks a clear scientific rationale. We evaluated concomitant medication usage during the first 6 months of the prospective, observational, European Schizophrenia Outpatient Health Outcomes (SOHO) study, examining its frequency, variation according to type of antipsychotic ...

OBJECTIVE: To evaluate guideline adherence in in-patient medication care of psychotic disorders. METHOD: A total of 508 persons with psychotic disorders were included in a naturalistic multisite hospital study. Subjects were assessed weekly on mental state, social functioning, socioeconomic factors and medication prescriptions. RESULTS: In total, 17% of individuals were ...

Clozapine is a distinctive antipsychotic agent, having a unique clinical profile and an idiosyncratic safety profile. More so than with other agents, the weighting of its adverse event profile is critical, in order to counterbalance its clear clinical advantages. The safety issues with clozapine are in a number of areas, ...

This study examined the efficacy of brief functional assessment methodologies, including descriptive assessment and contingency reversal conditions, in determining function of ADHD behavior and the effects of stimulant medication in regular classroom environments. Students diagnosed with ADHD participated in a double blind placebo controlled stimulant medication trial within this functional ...

Tardive dyskinesia (TD) is an umbrella term typically used to describe a movement disorder associated with the use of neuroleptic (anti-psychotic) medication. It is characterized by abnormal, repetitive and involuntary movements. The movements may be around the mouth and face (orofacial dyskinesia) and less frequently, in the trunk and limbs ...

This study extends a previous study of the factor structure of the neurologic examination in unmedicated schizophrenia, utilizing cluster analysis and adding a medicated condition. We administered a modified version of the Neurologic Evaluation Scale (NES) on two occasions to 80 patients with schizophrenia or schizoaffective disorder, once while on ...

OBJECTIVES: To estimate the frequency of neuropsychiatric disease (NPD) in an urban pediatric type 2 diabetes mellitus (T2DM) population, to compare demographic characteristics of affected patients with those unaffected with NPD, and to determine the frequency of psychotropic medication treatment. STUDY DESIGN: Retrospective chart review of patients with T2DM at ...

Niacin (vitamin B3) flushing--a marker of altered prostaglandin signaling--is indirectly linked to the phospholipid-prostaglandin metabolism. Diminished skin flushing was repeatedly found in schizophrenia, but has not been systematically investigated at different stages of disorder as yet. We compared niacin sensitivity of 32 first-episode and 32 multi-episode patients (mainly on stable ...

Many atypical antipsychotic medications are becoming available for clinical use. Ziprasidone is a recent addition to this group and is expected to become available for clinical use in Canada in 2005. Ziprasidone has some significant differences compared with other atypicals currently available in Canada. Clinicians need to understand the benefits ...

BACKGROUND: The potential cardiotoxicity of antipsychotic drugs is well known. The N-terminal fragment of B-type natriuretic peptide (NT-proBNP) is considered to be a possible biomarker in clinical practice for the diagnosis and prognosis in patients with suspected heart failure. This pilot evaluation tests the influence of antipsychotic drugs on NT-proBNP ...

The management of psychotropic medications during pregnancy and lactation involves a difficult and complex decision for both patient and provider, particularly due to the many unknown effects medication may have on the infant. Available studies concerning use of psychotropic medications in pregnant and lactating women are limited and there are ...

BACKGROUND: Bulimia nervosa and attention deficit hyperactivity disorder (ADHD) share several key features, including impulsivity and low self-esteem. Stimulant medications have been highly effective in the treatment of ADHD. However, medication management of bulimia with antidepressants has demonstrated only partial resolution of bulimic symptoms. To date, there are no published ...

OBJECTIVE: To address the issue of how much psychiatric residents should be taught about older medications. METHODS: Selective use of the literature, including historical overview, was employed to compare and contrast old and newer generation medications. RESULTS: While many old drugs are truly antiquated, medications such as typical antipsychotics, tricyclic ...

Aripiprazole is a recently released antipsychotic medication which differs from other atypical antipsychotic agents by its partial agonist activity at postsynaptic D2 receptors. It is administered orally and is distinguished by a long elimination phase half-life relative to other antipsychotic medications. Randomized studies have demonstrated the efficacy of aripiprazole relative ...

Although attention deficit hyperactivity disorder (ADHD) has been officially recognized as persisting into adulthood for more than 25 years, only recently has the condition been studied in adults. There is great syndromatic continuity between childhood and adult ADHD, and thus much of the medication management of adults with ADHD can ...

Schizophrenia is a chronic disabling disease which in the majority of cases requires long-term treatment with antipsychotic medication. Before the development of atypical antipsychotics, treatment choice was restricted to conventional (or typical) antipsychotics, which are known to cause a range of side effects including extrapyramidal symptoms. Although atypical agents provide ...

PURPOSE OF REVIEW: Atypical antipsychotic medications (second-generation antipsychotics) have been increasingly used in the treatment of a number of psychotic disorders since their introduction in 1988, with the newest medication introduced in 2002. Justification for their use includes claims of equal or improved antipsychotic activity over first-generation antipsychotics, increased tolerability, ...

Resting energy expenditure (REE) is lower than predicted in persons taking atypical antipsychotic medication, and weight management is a significant clinical challenge for some of them. However, to date there have been no published guidelines to assist clinicians in choosing appropriate prediction equations to estimate energy expenditure in persons taking ...

P300 amplitude reduction in schizophrenia is, according to previous studies, partially recovered by treatment with neuroleptics. However, whether this medication-induced P300 recovery is associated with duration of untreated psychosis (DUP) remains unreported; the present study is a preliminary examination of this question. Auditory P300 was recorded from 18 drug-naive and ...

Violent behaviour has a strong association with antisocial personality disorder (APD) and schizophrenia. Although developments in the understanding of socio-environmental factors associated with violence should not be ignored, advances in prevention and treatment of violent behaviour would benefit by improved understanding of its neurobiological and cognitive basis. The authors, therefore, ...

OBJECTIVE: To review serotonergic and dopaminergic system function in anorexia nervosa in terms of potential modulation by atypical antipsychotic medications. METHOD: A systematic review of clinical, neurobiological and functional neuroimaging findings of serotonergic and dopaminergic system activity in anorexia nervosa was conducted via MEDLINE, PsycINFO and EMBASE psychiatry databases, with ...

OBJECTIVE: Studies of how differences in systems of care, including cultural differences, affect prescribing practice and patient outcomes are important and can help answer questions such as the effectiveness of clozapine in routine practice. This study examined the use of clozapine in Maryland and in Victoria, Australia. METHODS: This study ...

PURPOSE OF REVIEW: The aim of this article is to critically review the current literature on treatment-refractory schizophrenia with an emphasis on emergent themes and key findings. RECENT FINDINGS: New information continues to emerge on the impact of each second-generation antipsychotic on the treatment-refractory patient population and on the traditionally ...

Psychiatrists commonly treat adolescents with multiple psychotropic medications simultaneously. We studied the effects of psychotropic medications on the weight of adolescent patients at Austin State Hospital between June 1997 and December 2001. The medication combinations that caused the largest weight increases were olanzapine with valproic acid, and olanzapine with venlafaxine. ...

The aim of this study was to determine whether wrist actigraphy could be used to assess the daytime effects of stimulant medication in the treatment of narcolepsy. Nine subjects with narcolepsy/cataplexy (medicated and unmedicated) were compared with matched control subjects. Data were collected over 4 days in the subjects' home. ...

Schizophrenic illness is associated with high rates of osteoporosis, the etiology of which remains obscure, but which may be at least partly explained by the prolactin-raising properties of antipsychotic medication. Conventional antipsychotics all cause hyperprolactinemia, whereas a limited number of atypical antipsychotic drugs do not. To investigate this further, we ...

Knowledge of current patterns of psychotropic medication use by disabled youths is an important starting point for targeting future efforts to improve prescribing practices. This study provides a retrospective, descriptive analysis of the prevalence and patterns of psychotropic medication among 1022 Kansas Medicaid youths in 2001 who were enrolled with ...

Effective treatments of bipolar disorder now extend to a panoply of choices that include various anticonvulsants and antipsychotics. Although lithium still has an important role, particularly in "classic" mania and suicide prevention, the other FDA-approved agents are better tolerated and more efficacious for mixed states and rapid cycling. It is ...

BACKGROUND: Medical morbidity and mortality rates remain elevated in schizophrenia patients compared with the general population, in part due to potentially reversible medical risk factors. Psychiatrists should address this problem by adopting established strategies for prevention and intervention. METHOD: The literature on modifiable medical risk factors relevant to individuals with ...

OBJECTIVE: The aim of this study was to evaluate current prescribing patterns of outpatient child psychiatrists in central New York. METHODS: Data were drawn from all active files of 1- to 18-year-olds (n = 1292) at eight outpatient treatment locations in central New York on one day in 2002. Age, ...

The high incidence of attention-deficit/hyperactivity disorder (ADHD) and escalating use of ADHD medications present a compelling case for clarifying the pathophysiology of, and developing laboratory or radiologic tests for, ADHD. Currently, the majority of specific genes implicated in ADHD encode components of catecholamine signaling systems. Of these, the dopamine transporter ...

Up to 90% of individuals with schizophrenia smoke cigarettes, and many show signs of heavy dependence. Although the severity of nicotine dependence is often measured by the six-item Fagerstrom Test for Nicotine Dependence (FTND), this measure, in its current form, may not be as appropriate in this population--or in others ...

OBJECTIVE: Delirium is a common condition frequently seen in consultation-liaison psychiatry. It is especially common among medically compromised patients, and is an indicator of the severity of the medical illness. In addition, it is associated with a higher morbidity, mortality, and longer hospitalization. Traditionally, haloperidol has been used to treat ...

This case history is one example of how patients can be switched to novel antipsychotic medications in persons with chronic and stable schizophrenia. This brief discussion offers several guidelines for switching novel antipsychotic medications. The decision to switch medications must be based on individual patient needs, variances, and preferences. Clinical ...

Atypical antipsychotics account for more than 60% of antipsychotic prescriptions written for the treatment of schizophrenia. While switching from one antipsychotic to another is a dynamic process, there has been no research on individual patient and institutional characteristics that predict antipsychotic switching. VA national administrative data were used to identify ...

OBJECTIVES: To describe the use of atypical antipsychotic medications in a Medicaid-enrolled population composed primarily of elderly and disabled patients. Our analyses focused upon the frequency of use of polytherapy with multiple antipsychotic medications and the prescribing of off-label dosages. METHODS: We conducted a cross-sectional retrospective analysis of oral antipsychotic ...

OBJECTIVE: This report synthesizes the literature describing the phenomenology, clinical importance and biology of subjective responses to antipsychotic medications in schizophrenia. A patient's experience of an antipsychotic is important because unpleasant or dysphoric responses can impair therapeutic relationships, lead to medication non-adherence, and have direct negative effects on a patient's ...

The use of psychotropic medications in eating disorder patients with personality disorders (PDs) is a complex topic. In this overview, we do not focus on individual studies, but rather on the philosophical issues and broader management principles of medications in this comorbid population. We review a general construct of personality ...

Attention-deficit hyperactivity disorder (ADHD) is a common disorder in children that frequently persists into adulthood. Studies have found that substance use disorders (SUD) are seen more commonly in those with ADHD than the general population. Although treatment with stimulant medications has been shown to be effective for individuals with ADHD, ...

The introduction of second-generation antipsychotics represents an important advance in the treatment of schizophrenia. Although these drugs are generally very effective, not all patients respond in the same way. Partial response with persistent positive and negative symptoms and residual symptoms may force physicians to change antipsychotic medication. As more and ...

Anorexia nervosa (AN) is a serious mental disorder, characterized by severely low weight and cognitive distortions about body shape and weight. AN is generally associated with a range of psychological symptoms, including depression, anxiety, obsessions, and rituals. The current study summarized findings from randomized controlled trials (RCT) using pharmacologic treatments ...

BACKGROUND: Younger age and a response to a supra-threshold levodopa challenge have been reported to predict a favorable response to bilateral subthalamic nucleus (STN) stimulation. OBJECTIVE: To identify and evaluate clinical factors which predict a positive outcome after bilateral STN stimulation in patients with Parkinson's disease, using each patient's typical ...

A new neuro-behavioral test with analysis algorithms has been developed for use in screening individuals for attention deficit hyperactivity disorder (ADHD) and for the quantitative evaluation of ADHD medication/therapy in diagnosed patients. This technique combines a 15 minute auditory-based test of attention with simultaneous EEG monitoring by a wireless, portable ...

OBJECTIVE: Research on psychiatric outcomes among individuals dually diagnosed with mild mental retardation and co-occurring mental illness who are treated with antipsychotic medication is markedly limited due to difficulties encountered in (1) making valid and reliable psychiatric diagnoses and (2) accurately rating and following psychiatric symptom change over time in ...

Medications with dopamine antagonist properties, such as haloperidol, and those with serotonin reuptake inhibitor properties, such as clomipramine, have been shown to improve fluency. To examine the degree to which each of these two pharmacological mechanisms might independently affect fluency, a selective serotonin reuptake inhibitor, paroxetine, and a selective dopamine ...