Detecting and Managing Adverse Effects of Antipsychotic Medications

Ames, Donna; Carr-Lopez, Sian M.; Gutierrez, Mary A.; Pierre, Joseph M.; Rosen, Jennifer A.; Shakib, Susan; Yudofsky, Lynn M.

doi:10.1016/j.psc.2016.01.008

Cited by 28 publications

(28 citation statements)

References 196 publications

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“…Another vital factor to be taken into consideration is the clinical safety information of each candidate. Although current antipsychotic medications have substantially decreased risk of extrapyramidal side-effects, they still are associated with a significant incidence of fatal events, in particular sudden cardiac death from arrhythmia (1,4,22). Given the outstanding safety profile of aripiprazole, the in vitro data provided in this study apparently warrants further pursuit of aripiprazole as an anticancer stem cell drug through preclinical and clinical studies.…”

Section: Discussionmentioning

confidence: 85%

Aripiprazole, an Antipsychotic and Partial Dopamine Agonist, Inhibits Cancer Stem Cells and Reverses Chemoresistance

Okada

Kuramoto

Takeda

et al. 2016

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Section: Discussionmentioning

confidence: 85%

Aripiprazole, an Antipsychotic and Partial Dopamine Agonist, Inhibits Cancer Stem Cells and Reverses Chemoresistance

Okada

Kuramoto

Takeda

et al. 2016

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“…Weight gain was relatively common with approximately 30% of individuals gaining >7% of body weight. Although many second-generation antipsychotic drugs are associated with weight gain (23), some of the weight gain in this sample could have been related to life-style issues seen in those residing in shelters or transitional housing. The formulation of paliperidone palmitate used in this study was the monthly injection version.…”

Section: Discussionmentioning

confidence: 94%

A 6-Month Prospective Trial of a Personalized Behavioral Intervention + Long-Acting Injectable Antipsychotic in Individuals With Schizophrenia at Risk of Treatment Nonadherence and Homelessness

Sajatovic

Ramirez

Fuentes-Casiano

et al. 2017

J Clin Psychopharmacol

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Purpose Long-acting injectable antipsychotic medication (LAI) can optimize adherence for high-risk serious mental illness (SMI). This Customized Adherence Enhancement approach delivered by social worker interventionists was combined with LAI (CAE-L) of paliperidone palmitate for homeless, poorly-adherent individuals with SMI. Methods This 6-month prospective, uncontrolled trial of CAE-L in 30 recently homeless individuals with SMI assessed adherence using the Tablets Routine Questionnaire (TRQ), injection frequency, and SMI symptoms measured by the Positive and Negative Syndrome Scale (PANSS), Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impressions (CGI). The Social and Occupational Functioning Assessment Scale (SOFAS) measured social function. Standardized scales assessed extrapyramidal effects. Findings Mean age was 43.6 years (SD=9.53), mainly minorities (86.7% African-American), mainly single/never married (72.4%). Rate of substance abuse within the past year was 40.0% and rate of incarceration within the past 6 months was 32.1%. Four (13.3 %) participants terminated the study prematurely. CAE-L was associated with good adherence to LAI (92.9%) and improved adherence with oral drug as measured by TRQ (p=.02). There were significant improvements in PANSS (p <.01), BPRS (p<.001), CGI (p =.003) and SOFAS (p=.005). There were no significant extrapyramidal effects. Implications While findings must be tempered by the methodological limitations, CAE-L appears associated with multiple domains of improvement in homeless / recently homeless individuals with SMI. Side effects limit tolerability in some individuals and not all will remain engaged. However, LAI combined with a patient-centered behavioral approach can improve outcomes for some high–risk individuals with SMI.

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“…The third need is studying the impact of the unique weight management problems faced by veterans, including mental health conditions such as PTSD and high levels of concomitant psychotropic medications use. 29 In addition, studies in the veteran population are needed to identify the best starting point for introducing pharmacotherapy, the most effective adjunctive behavioral treatments, and the role of intermittent vs. continuous therapy as well as duration of treatment.…”

Section: Hsrandd State Of the Art Conference On Weight Managementmentioning

confidence: 99%

Pharmacotherapy for Weight Management in the VHA

et al. 2017

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Weight management medications (WMM) are underutilized as an adjunct to behavioral and lifestyle interventions. In fiscal years 2014-2015, a total of approximately 2500 veterans-a mere 2% of veterans receiving care from the Veterans Health Administration (VHA)-eligible for a WMM received a prescription for one. A State of the Art Conference on Weight Management workgroup, focused on pharmacotherapy, developed evidence-based recommendations and strategies to foster the appropriate use of WMM in the VHA. The workgroup identified patient, prescriber, and health system barriers to and facilitators for prescribing WMM. Barriers included patient and provider concerns about medication safety and efficacy, limited involvement of primary care, restrictive medication criteria for use (CFU), and skepticism among providers regarding the safety and efficacy of WMM and the perception of obesity as a disease. Potential facilitators for removing barriers included patient and provider education about WMM and the health benefits of weight loss, increased engagement of primary care providers in weight management, relaxation of the CFU, and creation of a system to help patients navigate through weight management treatment options. Several research questions were framed with regard to WMM in general, and specifically to the care of obese veterans. While some of the workgroup's conclusions reflect issues specific to the VHA, many are likely to be applicable to other health organizations.

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Detecting and Managing Adverse Effects of Antipsychotic Medications

Cited by 28 publications

References 196 publications

Aripiprazole, an Antipsychotic and Partial Dopamine Agonist, Inhibits Cancer Stem Cells and Reverses Chemoresistance

Aripiprazole, an Antipsychotic and Partial Dopamine Agonist, Inhibits Cancer Stem Cells and Reverses Chemoresistance

A 6-Month Prospective Trial of a Personalized Behavioral Intervention + Long-Acting Injectable Antipsychotic in Individuals With Schizophrenia at Risk of Treatment Nonadherence and Homelessness

Pharmacotherapy for Weight Management in the VHA

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