Abstract:
:In recent years, the use of antipsychotics has been widely debated for reasons concerning their safety in elderly patients affected with dementia. To update the use of antipsychotics in elderly demented people, a MEDLINE search was conducted using the following terms: elderly, conventional and atypical antipsychotics, adverse events, dementia, and behavioral and psychotic symptoms in dementia (BPSD). Owing to the large amounts of studies on antipsychotics, we mostly restricted the field of research to the last 10 years. Conventional antipsychotics have been widely used for BPSD; some studies showed they have an efficacy superior to placebo only at high doses, but they are associated with several and severe adverse effects. Atypical antipsychotics showed an efficacy superior to placebo in randomized studies in BPSD treatment, with a better tolerability profile versus conventional drugs. However, in 2002, trials with risperidone and olanzapine in elderly patients affected with dementia-related psychoses suggested the possible increase in cerebrovascular adverse events. Drug regulatory agencies issued specific recommendations for underlining that treatment of BPSD with atypical antipsychotics is "off-label." Conventional antipsychotics showed the same likelihood to increase the risk of death in the elderly as atypical agents, and they should not replace the atypical agents discontinued by Food and Drug Administration warnings. Before prescribing an antipsychotic drug, the following are factors to be seriously considered: the presence of cardiovascular diseases, QTc interval on electrocardiogram, electrolytic imbalances, familiar history for torsades des pointes, concomitant treatments, and use of drugs able to lengthen QTc. Use of antipsychotics in dementia needs a careful case-by-case assessment, together with the possible drug-drug, drug-disease, and drug-food interactions.
journal_name
J Clin Psychopharmacoljournal_title
Journal of clinical psychopharmacologyauthors
Gareri P,De Fazio P,Manfredi VG,De Sarro Gdoi
10.1097/JCP.0b013e3182a6096esubject
Has Abstractpub_date
2014-02-01 00:00:00pages
109-23issue
1eissn
0271-0749issn
1533-712Xjournal_volume
34pub_type
杂志文章,评审abstract::Phenomenological, physiological, biochemical, and receptor binding measures are useful as dependent variables in affective disorders research. Abnormalities of these measures can result from up-regulation and supersensitivity of cholinergic systems and disturbances of cholinergic-monoaminergic interaction. These devia...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章,评审
doi:
更新日期:1986-04-01 00:00:00
abstract::Switching antipsychotic regimen to agents with low weight gain potential has been suggested in patients who gain excessive weight on their antipsychotic therapy. In an open-label pilot study, we evaluated the metabolic and psychiatric efficacy of switching to aripiprazole in 15 (9 men, 6 women) outpatients with schizo...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章
doi:10.1097/JCP.0b013e3180a9076c
更新日期:2007-08-01 00:00:00
abstract::Lithium alone or in combination with other psychotherapeutic drugs has long been the gold standard of management for bipolar disorder (BD). Recognition of its limitations in the acute and chronic management of BD has led to the development of alternative therapies. One such approach involves the use of antiepileptic d...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章,评审
doi:10.1097/00004714-200212000-00010
更新日期:2002-12-01 00:00:00
abstract::In this study, the authors investigated the relationship between the metabolism of clomipramine (C) and the genotypes of cytochrome P450 (CYP) CYP2C19 and CYP2D6. Fifty-one Japanese patients (18 men and 33 women) were administered 10 to 250 mg/day of C by mouth and maintained on the same daily dose of C for at least 2...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章
doi:10.1097/00004714-200112000-00002
更新日期:2001-12-01 00:00:00
abstract::Over the past 10 years, knowledge gained about the pharmacokinetic profiles of valproate and carbamazepine has increased the clinical effectiveness of their use. Much of the information has been gained through their use as successful antiepileptic medications. As these agents begin to play an increasing role as mood-s...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章
doi:10.1097/00004714-199202001-00010
更新日期:1992-02-01 00:00:00
abstract:PURPOSE/BACKGROUND:Many investigators reported that pharmacological treatment of female sexual dysfunction (FSD) has been a promising field yet to be explored. The purpose of this pilot study was to investigate the efficacy and safety of a topical cream containing small concentrations of three vasodilators with differe...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章,随机对照试验
doi:10.1097/JCP.0000000000000811
更新日期:2018-02-01 00:00:00
abstract::Apoptosis has been considered to be involved in schizophrenia. Water channels are modulated just before apoptosis. In the aquaporin family, aquaporin 4 (AQP-4) is most highly expressed in the brain and is supposed to play an important role in a neuronal environment. In this clinical study, we investigated the relation...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章,随机对照试验
doi:10.1097/JCP.0b013e31825370f4
更新日期:2012-06-01 00:00:00
abstract::Forty bipolar depressed inpatients underwent three consecutive cycles of total sleep deprivation (TSD). At the beginning of the study, 20 patients were free of psychotropic drugs and 20 had been receiving lithium medication for at least 6 months. Mood was rated on the Hamilton Rating Scale for Depression before and af...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章
doi:10.1097/00004714-199906000-00007
更新日期:1999-06-01 00:00:00
abstract:PURPOSE/BACKGROUND:The use of clozapine, particularly in young people, is often limited by early treatment-emergent adverse effects including drowsiness and lethargy. Concerns about adverse effects, medication adherence, and the need for blood monitoring often impede the use of clozapine in this population, leading to ...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章
doi:10.1097/JCP.0000000000000860
更新日期:2018-06-01 00:00:00
abstract::We compared acute effects of single intravenous administrations of metoclopramide (40 mg) and placebo in a double-blind crossover study involving 81 patients with tardive dyskinesia. Metoclopramide produced significantly greater reduction in mean total Abnormal Involuntary Movement Scale score as well as in ratings fo...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1982-12-01 00:00:00
abstract::Weight gain is a problem commonly encountered with antipsychotic treatment and has become more apparent with increasing use of the newer atypical antipsychotics. The adipocyte-derived hormone, leptin, has been associated with body weight and energy homeostasis, and abnormal regulation of leptin could play a role in we...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章
doi:10.1097/jcp.0b013e3180582412
更新日期:2007-06-01 00:00:00
abstract::The aim of this study was to estimate the long-term effectiveness of olanzapine as adjunctive therapy in patients with bipolar disorder who exhibited an inadequate response to mood stabilizers. Twenty-three Research Diagnostic Criteria (RDC) patients with bipolar I and II were assessed by means of the Schedule for Aff...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章
doi:10.1097/00004714-200110000-00002
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVES:To determine if prolactin levels are associated with glucose-insulin homeostasis in antipsychotic-treated patients with schizophrenia. METHOD:Prolactin levels and glucose homeostasis (quantified using oral glucose tolerance testing, insulin measurement, and homeostasis model assessment) were measured in 15 ...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章
doi:10.1097/01.jcp.0000239791.91330.48
更新日期:2006-12-01 00:00:00
abstract::A case of rhabdomyolysis is described, with onset following three intramuscular injections of loxapine and one injection of benztropine over a 7-hour period. The possible additive effects of intramuscular drug administration and psychotic episode-associated increased muscle membrane permeability are discussed. Because...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章
doi:
更新日期:1984-02-01 00:00:00
abstract::Methamphetamine has become a major public health issue globally, particularly in the United States. Despite this, no effective pharmacotherapy for methamphetamine abuse has been developed to date. This 6-week, open-label pilot clinical trial examined the safety and tolerability of modafinil up to 400 mg/d in 8 methamp...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章
doi:10.1097/JCP.0b013e3181b591e0
更新日期:2009-10-01 00:00:00
abstract::Four patients with obsessive-compulsive disorder (DSM-III and RDC) were treated in an open trial with alprazolam. Moderate to marked improvement was noted in the degree of obsessionality, anxiety with motor tension, and secondary affective changes. The mixed anxiolytic-antidepressant properties of alprazolam are theor...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章
doi:
更新日期:1985-02-01 00:00:00
abstract::Serum neuroleptic activity by radioreceptor assay and prolactin concentration were measured every 6 months for 2 years in 105 male schizophrenic outpatients. The patients took a variety of neuroleptics at clinically determined doses. As expected, when four dissimilar neuroleptics were examined together, there was no s...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章
doi:
更新日期:1989-10-01 00:00:00
abstract::The pharmacokinetic parameters of clozapine and its two main metabolites, N-desmethylclozapine (norclozapine, active metabolite) and clozapine N-oxide, were evaluated, after oral administration, in 19 patients with chronic schizophrenia. Plasma and red blood cell (RBC) drug concentrations were determined by high-perfo...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章
doi:10.1097/00004714-199812000-00010
更新日期:1998-12-01 00:00:00
abstract::A multicenter, double-blind, 12-week, placebo-controlled trial of 411 randomized patients, predominantly women diagnosed with posttraumatic stress disorder, failed to show a difference between either dose of fluoxetine treatment and placebo. The mean changes from baseline (SD) measured by the Clinician-Administered PT...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/JCP.0b013e31803308ce
更新日期:2007-04-01 00:00:00
abstract::We examined kinetic and dynamic factors to determine the pharmacological and behavioral safety and tolerability of low versus high doses of an opiate antagonist, naltrexone (50 mg/day vs. 100 mg/day), and acamprosate (2 g/day vs. 3 g/day), a functional N-methyl-D-aspartate receptor antagonist, both independently and c...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.jcp.0000084029.22282.bb
更新日期:2003-06-01 00:00:00
abstract::This study aimed to assess whether exposure to anticholinergic and sedative medications and its evolution was associated with increased risk of in-hospital falls and all-cause mortality. Furthermore, results were compared with 2 definitions of drug burden index (DBI) against the outcomes.This observational, multicentr...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章,多中心研究
doi:10.1097/JCP.0000000000000195
更新日期:2014-10-01 00:00:00
abstract::Paroxetine is a novel phenylpiperidine antidepressant agent that acts as a potent and selective inhibitor of serotonin reuptake. We report results of a 6-week, randomized, double-blind, multicenter study comparing paroxetine and fluoxetine in the treatment of major depression. One hundred seventy-eight inpatients, who...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00004714-199312002-00003
更新日期:1993-12-01 00:00:00
abstract::Lithium is clinically available for the treatment of mood disorders. However, it has remained unclear how lithium acts on the brain to produce its effects. The aim of this study was to evaluate the effects of chronic lithium on human brain activity using positron emission tomography and clarify the correlation between...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章
doi:10.1097/jcp.0b013e31815a23c2
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVE:A serious side effect of atypical antipsychotics is increased body weight, which leads to further morbidity and nonadherence to medication. It has been suggested that both genetic and nongenetic variables may influence antipsychotics-related weight gain. This study aimed to simultaneously explore the effects ...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章
doi:10.1097/01.jcp.0000203196.65710.2b
更新日期:2006-04-01 00:00:00
abstract::The quest for additional effective therapies for bipolar study commenced in the 1960s, even before regulatory approval of lithium. This was driven by the recognition that patient response to lithium varied from excellent to poor; thus, significant numbers of patients faced its frequent adverse effects and risks withou...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章,评审
doi:10.1097/00004714-199604001-00006
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND:We examined the influence of prior antidepressant treatment trials on the likelihood of depressive relapse, and time to depressive relapse, during maintenance therapy of bipolar II disorder in treatment-responsive subjects who had recovered from a major depressive episode. METHODS:Data were derived from a p...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章
doi:10.1097/JCP.0000000000001049
更新日期:2019-07-01 00:00:00
abstract::The aim of this study was to evaluate the efficacy and tolerability of tiagabine in adult patients with post-traumatic stress disorder (PTSD). This 12-week, multicenter, double-blind study randomized patients to receive either tiagabine or placebo. Tiagabine (administered in divided doses) was initiated at 4 mg/d (2 m...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/JCP.0b013e31802e5115
更新日期:2007-02-01 00:00:00
abstract::Quetiapine (QTP) combined with lithium (Li) or divalproex (DVP) for the treatment of mania was evaluated in 2 double-blind, placebo-controlled studies. Patients were randomized to 3 or 6 weeks of treatment with QTP plus Li/DVP or placebo (PBO) plus Li/DVP. Quetiapine was dosed up to 800 mg/d; Li was dosed to achieve s...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.jcp.0000144887.66319.2f
更新日期:2004-12-01 00:00:00
abstract::In a double-blind, parallel groups study, 60 healthy student volunteers (29 men and 31 women, aged 19-22 years) were randomly allocated to receive placebo, 100 or 200 mg modafinil. Two hours later, in the early evening, they completed an extensive cognitive battery. The 3 groups did not differ in self-ratings of sleep...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.jcp.0000155816.21467.25
更新日期:2005-04-01 00:00:00
abstract::There have been several case reports of improvement in tardive dyskinesia (TD) after treatment with calcium-blocking agents. We have conducted prior single-blind (rater-blind) studies of verapamil and diltiazem and found a statistically significant improvement in TD with verapamil, and a small improvement that did not...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章
doi:10.1097/00004714-199010060-00006
更新日期:1990-12-01 00:00:00