Quetiapine <i>versus</i> aripiprazole in the management of schizophrenia

Shafti, Saeed Shoja; Kaviani, Hamid

doi:10.1177/2045125315579870

Cited by 7 publications

(3 citation statements)

References 23 publications

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“…We included a total of 278 RCTs (see flow diagram in the online supplement); one systematic review of 138 trials (N=47,189) ( 17 ) and 24 additional trials (N=6,672) ( 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ) for SGAs versus other SGAs, and one systematic review of 111 trials (N=118,503) ( 45 , 46 ) and five additional trials (N=1,055) ( 35 , 47 , 48 , 49 , 50 ) for FGAs versus SGAs. The two systematic reviews also included 33 cohort studies (N =652,505) ( 17 , 45 , 46 ).…”

Section: Resultsmentioning

confidence: 99%

Updating the Comparative Evidence on Second‐Generation Antipsychotic Use With Schizophrenia

McDonagh¹,

Dana²,

Selph³

et al. 2020

PRCP

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The objective of this study was to conduct a systematic review of literature comparing second-generation antipsychotics (SGAs) with each other and with firstgeneration antipsychotics (FGAs) in treating schizophrenia. Methods: MEDLINE, the Cochrane Library, and PsycINFO databases were searched through January 2020. Following standard methods, recent high-quality systematic reviews of each drug comparison and subsequently published primary studies were included to update the meta-analyses with any new data. Two reviewers independently conducted study selection, abstraction, and quality assessment. Results: Two systematic reviews and 29 newer trials (total of 162 trials of SGAs, N¼53,861; 116 trials of SGAs versus FGAs, N¼119,558) were included. Most trials were of fair quality, industry-funded, and included older SGAs and a few recently approved SGAs (asenapine, lurasidone, iloperidone, cariprazine, brexpiprazole and long-acting injection [LAI] formulations of aripiprazole and paliperidone). Older SGAs had similar effects on function, quality of life, mortality, and adverse event incidence, although clozapine improved symptoms more than most other drugs and olanzapine and risperidone were superior to some other drugs. Olanzapine, risperidone, ziprasidone, and aripiprazole performed similarly on outcomes of benefit compared with haloperidol. Risperidone LAI and olanzapine resulted in fewer withdrawals due to adverse events, but risk of diabetes increased with olanzapine. Haloperidol had greater incidence of adverse events than did olanzapine and risperidone, but similar effects on other outcomes. Conclusions: Most comparative evidence favored older SGAs, with clozapine, olanzapine, and risperidone superior on more outcomes than other SGAs. Older SGAs had similar benefits as haloperidol but with fewer adverse events.

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Section: Resultsmentioning

confidence: 99%

Updating the Comparative Evidence on Second‐Generation Antipsychotic Use With Schizophrenia

McDonagh¹,

Dana²,

Selph³

et al. 2020

PRCP

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“…Partial agonists across dopaminergic and opioidergic systems have been used with some success in alleviating the symptoms of BPD. For example, there is anecdotal evidence for the use of buprenorphine [18] and some randomised clinical trials examining the efficacy of aripiprazole in the treatment of BPD [19][20][21]. Their success seems to hinge on the ability to modulate and stabilise neurotransmitters implicated in the symptom domain of BPD.…”

Section: Introductionmentioning

confidence: 99%

Brexpiprazole Attenuates Aggression, Suicidality and Substance Use in Borderline Personality Disorder: A Case Series

Francis,

Ganasan,

Sulaiman

2024

Medicina

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Background: Borderline personality disorder (BPD) is a heterogeneous and highly comorbid disorder. Suicidality, aggression and substance abuse are common presentations of BPD. Our case series is the first to highlight the role of brexpiprazole in improving these symptoms in patients with BPD. Case presentation: We describe three cases demonstrating the role of brexpiprazole in improving BPD’s prominent features and comorbidities. All cases improved when brexpiprazole was added to their treatment regime. Case 1: A 26-year-old woman who was diagnosed with BPD and cyclothymia, presented to the psychiatric emergency unit with impulsive suicidal behaviour. Case 2: A 43-year-old woman suffering from BPD sought help due to her violent behaviour and emotional dysregulation. Case 3: A 22-year-old woman with underlying attention deficit and hyperactivity disorder, polysubstance use disorder and BPD presented with dysregulated emotions. Conclusions: Our case series provides anecdotal evidence of the potential role of brexpiprazole in attenuating suicidality, aggression and substance abuse in patients with BPD. We postulate that brexpiprazole’s high affinity for the 5HT1A/5HT2A receptors, coupled with its low intrinsic effect on the D2/D3 receptor system, is fundamental in its actions to stabilise the aberrant dopaminergic and serotonergic signalling in BPD. Future research should focus on well-designed clinical trials investigating the efficacy of brexpiprazole in patients with BPD.

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“…Specific attention, also, has been paid to the role of glutamate and its receptor in schizophrenia, mostly due to abnormal levels of glutamate receptors that have been found in the postmortem brains of schizophrenic patients [Jones and Pilowsky, 2002], and the finding that glutamate-blocking drugs such as ketamine and phencyclidine may simulate the signs and symptoms of schizophrenia [Konradi and Heckers, 2003]. Antipsychotics are effective in both the acute and maintenance treatment of schizophrenia and other psychotic disorders [Tandon et al 2008; Shoja Shafti and Kaviani, 2015]. While antipsychotic medication remains the mainstay of treatment for schizophrenia and has been in use for a long time, as evidenced by ongoing research and partial effectiveness of the antipsychotics on cognitive and negative symptoms, the search is on for drugs that may improve these domains of functioning for someone suffering from schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of rivastigmine on positive, negative, and cognitive symptoms of schizophrenia: a double-blind clinical trial

Shafti

Khoei

2016

Therapeutic Advances in Psychopharmacology

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Background: Several lines of evidence suggest that the cholinergic system may be disrupted in schizophrenia and so this may contribute to the cognitive impairments of schizophrenic patients. Because such deficits do not respond to neuroleptic treatment, different approaches have been done by acetylcholinesterase inhibitors (AChEIs). The objective of the present assessment was to evaluate the safety and clinical effects of rivastigmine, as an adjunctive drug, on the clinical symptoms of schizophrenia. Methods: A total of 46 patients with a diagnosis of schizophrenia entered into a 12-week, double-blind, clinical trial for random assignment to rivastigmine or placebo, as adjuvant to their current antipsychotic medication. Positive and Negative Symptom Scale (PANSS) and Mini Mental State Examination (MMSE) had been used as the primary outcome measures. Clinical Global Impressions-Improvement (CGI-I) Scale and Extrapyramidal Symptom Rating Scale (ESRS) had been used as the secondary measures. Treatment efficacy was evaluated by a Student's t test and repeated-measures analysis of variance (ANOVA). Statistical significance was defined as a two-sided p value ⩽ 0.05. Cohen's standard (d) and correlation measures of effect size (r) had been calculated for comparing baseline to endpoint changes. Results: According to the findings, except for significant enhancement of MMSE by rivastigmine (p < 0.001), no significant improvement in PANSS (negative symptoms), PANSS (positive symptoms), and PANSS (general psychopathology) was evident in the target group. Also, except for significant improvement of CGI-I by rivastigmine in intragroup analysis, no significant effectiveness was evident in between-group analysis or repeated-measures ANOVA. ESRS, also, did not show any significant alteration in either group. Effect size (ES) analysis showed a large improvement in MMSE by rivastigmine. Conclusions: According to the findings, while rivastigmine could not induce significant improvement of positive and negative symptoms of schizophrenia, it caused significant enhancement of cognitive function in this group of patients.

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Quetiapine versus aripiprazole in the management of schizophrenia

Cited by 7 publications

References 23 publications

Updating the Comparative Evidence on Second‐Generation Antipsychotic Use With Schizophrenia

Updating the Comparative Evidence on Second‐Generation Antipsychotic Use With Schizophrenia

Brexpiprazole Attenuates Aggression, Suicidality and Substance Use in Borderline Personality Disorder: A Case Series

Effectiveness of rivastigmine on positive, negative, and cognitive symptoms of schizophrenia: a double-blind clinical trial

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