Topic
Psychotropic drug
About: Psychotropic drug is a research topic. Over the lifetime, 2309 publications have been published within this topic receiving 54070 citations.
Papers published on a yearly basis
Papers
More filters
TL;DR: The perception of clinicians is to reserve antipsychotic polypharmacy for severe, persistent and difficult-to-treat cases, and this was confirmed by the finding that patients discharged on two or more antipsychotics were more severely ill on admission.
Abstract: A recent survey of clinicians' opinions suggested that antipsychotic polypharmacy is reserved for particularly severe cases, and that it is intended to avoid high doses of a single drug. In the present study, we tested these clinicians' reasons for antipsychotic polypharmacy in a sample of Italian psychiatric inpatients. During a 6-year recruitment period, all psychiatric patients receiving antipsychotic therapy at discharge from an inpatient facility were included. Sociodemographic and clinical data were collected, and the 18-item version of the Brief Psychiatric Rating Scale was administered on admission and before discharge. At discharge, data on length of inpatient stay, psychotropic drug therapy and treatment adherence were collected. Prescribed daily doses were converted into multiples of the defined daily doses. A total of 354 inpatients receiving antipsychotic treatment at discharge were included. Of these, 100 (28%) were discharged with two or more antipsychotic drugs. After background group differences were controlled for, positive symptoms, manic/hostility symptoms and polypharmacy on admission were predictors of polypharmacy at discharge. The risk of high-dose antipsychotics in patients receiving polypharmacy at discharge was 10-fold higher than that in patients receiving one antipsychotic (odds ratio 10.70, 95% confidence interval 4.78-23.97, P<0.001). The perception of clinicians is to reserve antipsychotic polypharmacy for severe, persistent and difficult-to-treat cases, and this was confirmed by the finding that patients discharged on two or more antipsychotic agents were more severely ill on admission. Conversely, the theoretical advantage of avoiding a high dose of a single drug is counterbalanced by the documented disadvantage of administering high total doses.
71 citations
TL;DR: A preliminary study is presented, involving 34 schizophrenic children, 6 to 12 years of age, who were carefully observed following discontinuation of active neuroleptic treatment to ascertain the clinical effects of drug withdrawal to discuss the syndrome of tardive dyskinesia observed in adult schizophrenics.
Abstract: A preliminary study is presented, involving 34 schizophrenic children, 6 to 12 years of age, who were carefully observed following discontinuation of active neuroleptic treatment to ascertain the clinical effects of drug withdrawal. The children had been on maintenance therapy for periods of 6 to 15 months. Five neuroleptics were involved: fluphenazine, haloperidol, thioridazine, trifluoperazine, and thiothixene. All but two children suffered massive clinical relapse within 1 to 2 weeks after drug withdrawal. Fourteen of the children exhibited neurological withdrawal emergent symptoms (WES) characterized by involuntary movements and ataxia. In half the children the WES remitted spontaneously. In the remainder, symptoms disappeared within two weeks of resumption of active treatment with another neuroleptic. The findings are discussed in relation to the syndrome of tardive dyskinesia observed in adult schizophrenics.
70 citations
TL;DR: Results from a survey conducted in West London in 1977 show the 2-week prevalence of psychotropic drug consumption was found to be 10.9% and almost identical figure to that obtained in an earlier survey conducted 8 years previously.
Abstract: This paper presents some results from a survey conducted in West London in 1977. The 2-week prevalence of psychotropic drug consumption was found to be 10.9% and almost identical figure to that obtained in an earlier survey conducted 8 years previously. The reasons for the absence of the expected rise in prevalence of consumption are discussed. Consumption was found to be strongly associated with various measures of health, and there was a marked sex difference in drug consumption (females greater than males) which was independent of health.
70 citations
TL;DR: Given the complexity of bipolar disorder and its management, a switch of a mood stabilizer would be best done by a psychiatrist and take into account status of the condition being treated, efficacy, side effect profile, required laboratory monitoring and cost of the drug(s) being considered, and patient's pregnancy status or plan.
Abstract: Our review describes potential weight-altering effects of psychotropic medications (antipsychotics, antidepressants, anti-anxiety medications, mood stabilizers, sedative-hypnotics, medications for attention-deficit/hyperactivity disorder, and other psychotropic medications) and offers guidance on switching a medication if its weight-altering effect becomes problematic. For second-generation antipsychotics, the risk of weight gain is high with clozapine and olanzapine, low with amisulpride, aripiprazole, and ziprasidone, and medium with other second-generation antipsychotics. Switching from a high-risk antipsychotic to a low-risk antipsychotic usually mitigates or reverses weight gain. For second-generation antidepressants, there may be modest weight loss with bupropion and modest weight gain with mirtazapine and paroxetine. Other second-generation antidepressants are weight neutral but individual variations can occur. If significant change in weight occurs, switching to or adding a low-risk second-generation antidepressant should be considered. Mood stabilizers include lithium, valproate, carbamazepine, lamotrigine, oxcarbazepine, and most second-generation antipsychotics. Risk of weight gain is high with lithium and valproate and low with carbamazepine, lamotrigine, and oxcarbazepine. Given the complexity of bipolar disorder and its management, a switch of a mood stabilizer would be best done by a psychiatrist. Benzodiazepines, non-benzodiazepine and melatonergic hypnotics, doxepin, and trazodone are weight neutral. Diphenhydramine may cause weight-gain and can be switched to a weight-neutral hypnotic if needed. Stimulants can cause varying degrees of weight loss and switching to atomoxetine or bupropion may reverse this problem. If that fails, switching to clonidine or guanfacine can be tried. Switching must be evidence-based and take into account status of the condition being treated, efficacy, side effect profile, potential drug-drug interactions, required laboratory monitoring and cost of the drug(s) being considered, and patient's pregnancy status or plan. Non-pharmacological interventions both for mental disorders and overweight/obesity must be fully availed.
70 citations
TL;DR: Wang et al. as discussed by the authors examined the association between parent-adolescent conflict and adolescent adjustment in Chinese adolescents using children's and parents' reports of parent-teenager conflict.
Abstract: The association between parent-adolescent conflict and adolescent adjustment was examined in 429 Chinese adolescents using children's and parents' reports of parent-adolescent conflict. Results generally showed that parent-adolescent conflict based on ratings obtained from different sources were significantly related to measures of psychological well-being (general psychiatric morbidity, life satisfaction, purpose in life, hopelessness, and self-esteem), school adjustment (perceived academic performance and school conduct) and problem behavior (smoking and psychotropic drug abuse). The findings suggest that there is an intimate link between parent-adolescent conflict and the psychosocial adjustment, particularly the positive mental health, of Chinese adolescents.
69 citations