Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Well-known adverse effects of amisulpride include nausea, insomnia or tiredness, gastrointestinal, extrapyramidal and endocrine symptoms. Cardiac disorders, however, appear to be an extremely rare complication of the drug. Only a few case reports on this complication have been published so far, which deal with QT prolongation, hypotension, hypertension and palpitations. Bradycardia has not yet been mentioned. Here, we will report on a case of asymptomatic bradycardia that developed subsequent to therapeutic doses of amisulpride in a 25-year-old male patient with chronic paranoid-hallucinatory schizophrenia. The patient had been rehospitalized for an acute exacerbation of the psychosis. When the patient failed to respond at the beginning of hospitalization, the treatment was changed from clozapine to amisulpride. After a complete switchover to amisulpride, the patient's ECG showed sinus bradycardia and QT prolongation. When the daily dose of amisulpride was reduced from 800 mg/d to 600 mg/d, the patient's ECG quickly normalized (including blood pressure and pulse rate) within a few days. The patient did not report any cardiovascular-related complaints. Since the cardiovascular-specific diagnostics did not yield any indicative results, bradycardia may be a rare complication of amisulpride treatment.
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PMID:Asymptomatic bradycardia associated with amisulpride. 1177 48

The aim of this study was to evaluate the effectiveness of newer atypical antipsychotic drugs in comparison to clozapine for schizophrenia. Publications in all languages were searched from all relevant databases and all randomized controlled trials comparing clozapine with newer atypical drugs were included. The review and meta-analysis includes eight studies, most of them short in duration. Newer atypical drugs were broadly similar to clozapine when improvement was measured using a psychosis symptom rating scale or a global index. There was a trend for clozapine to be more effective than the others for positive symptoms, and less effective for the negative symptoms. The adverse effect profile of clozapine and newer atypical drugs was dissimilar: while clozapine produced more fatigue, hypersalivation, and orthostatic dizziness, new atypical drugs, with the exception of olanzapine, produced more extrapyramidal symptoms. As these results were obtained from few studies and a relatively small amount of patients, the equal effectiveness and tolerability of new atypical drugs in comparison with clozapine is not yet demonstrated. More trials of sufficient power, with longer duration, and measuring clinically important outcomes are urgently needed.
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PMID:Newer atypical antipsychotic medication in comparison to clozapine: a systematic review of randomized trials. 1208 13

Patients with schizophrenia experience cognitive impairments associated with hypofunctioning of the frontal cortex. Modafinil, a novel wake-promoting agent, works through the sleep-wake centers of the brain to activate the cortex. This 4-week, open-label, pilot study evaluated adjunct modafinil in patients with schizophrenia or schizoaffective disorder. Eleven patients received once-daily oral doses of modafinil (100 mg/day, days 1-14; 100 or 200 mg/day, days 15-28) in addition to antipsychotic therapy. Modafinil significantly improved patients' global functioning as assessed by a blinded clinician (week 2, P = 0.026; week 4, P = 0.012) and the investigator (week 3, P = 0.035). Modafinil significantly improved overall clinical condition, with 64% and 82% of patients rated as clinically improved at week 4 by a blinded clinician and the investigator respectively. Eighty-nine percent of patients considered themselves to be clinically improved. Modafinil significantly improved fatigue (P = 0.025, week 3) and tended to improve cognitive functioning scores. Control of positive symptoms was well maintained. Treatment-emergent adverse events included dry mouth (n = 2) and hallucinations (n = 2). One patient discontinued the study because of hallucinations that were considered to be possibly related to inadequate antipsychotic therapy. Although preliminary, these results suggest modafinil may be an effective and well-tolerated adjunct treatment that improves global functioning and clinical condition, and reduces fatigue in patients with schizophrenia or schizoaffective disorder. Additional controlled studies are warranted.
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PMID:Benefits of adjunct modafinil in an open-label, pilot study in patients with schizophrenia. 1509 Sep 36

This UK multicenter, noncomparative, open-trial study assessed risperidone in 74 first-psychotic-episode patients (DSM-IV schizophrenia) treated with flexible doses. Treatment commenced at 1 mg/day, increasing to 2 mg after 3 days; then adjusted to 8 mg/day maximum. Treatment duration was 12 weeks (Phase 1) with follow-up of 62 patients to 1 year on risperidone or another antipsychotic (Phase 2). Superiority over baseline was recorded on all Positive and Negative Syndrome Scale (PANSS) subscale scores at week 12 (P < 0.0001), occurring after 3 days of treatment. Clinical Global Impression of Severity of Illness and Improvement (CGI-Severity) significantly improved over Phase 1 (80% of patients improved, 1% deteriorated). Treatment was considered from being very to quite acceptable in 79% and a success in 77% (P = 0.0001). Only 5 patients switched to another antipsychotic. Significant improvements were maintained to 1 year. Treatment-related adverse events reported by > 10% of patients in Phase 1 were somnolence (23%) and fatigue (10.8%). Five patients stopped risperidone due to adverse events. Nine patients reported that adverse events started in Phase 2, and 3 patients stopped risperidone. Twenty-one patients (28%) in Phase 1 and 4 patients (6%) in Phase 2 (including a patient taking thioridazine) reported extrapyramidal symptoms (EPS); none stopped treatment. There was no significant change in Abnormal Involuntary Movement Scale (AIMS) or Targeting Abnormal Kinetic Effects (TAKE) scale at 12 weeks. No significant change in AIMS and a significant improvement in TAKE scale were found from week 12 to 1 year. There was no significant difference in efficacy and tolerability between 1- to 4-mg/day and 5- to 8-mg/day dose groups in Phase 1 or 2. Low-dose risperidone is concluded to be effective and well tolerated in first episode psychosis. Only 2 patients (3%) required doses of over 6 mg/day.
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PMID:A trial of low doses of risperidone in the treatment of patients with first-episode schizophrenia, schizophreniform disorder, or schizoaffective disorder. 1520 70

The aim of this study was to investigate depressive symptomatology across distinct major psychiatric disorders. A total of 1351 subjects affected by major depressive disorder (MDD = 389), bipolar disorder (BP = 511), delusional disorder (DD = 93) and schizophrenia (SKZ = 358) were included in our study. Subjects were assessed using the Operational Criteria for Psychotic Illness checklist (OPCRIT). The most frequently represented depressive symptoms in MDD were Loss of energy/tiredness, Loss of pleasure, Poor concentration, and Sleep disorders. Compared with MDD, BP had higher occurrences of Agitated activity, Excessive sleep, and Increased appetite and/or Weight gain, as well as lower Loss of pleasure. In our sample, 32.3% and 26.8% of DD and SKZ, respectively, had quite consistent depressive symptomatology, with at least four or more depressive symptoms. The most common depressive symptoms were Sleep disorders, Poor concentration and Loss of energy/Tiredness, followed by Psychomotor symptoms in SKZ only. Excessive self-reproach, Suicidal ideation, and Appetite and/or Weight changes were more specific to mood disorders. Finally, compared with SKZ, DD suffered from more depressive symptoms and had more severe depressive symptomatology. A quite consistent level of depressive symptomatology is therefore present in subpopulations of delusional and schizophrenic subjects other than in affective subjects. We identified some symptoms that are common across all major psychoses and symptoms that are more specific to each group.
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PMID:Depressive syndrome in major psychoses: a study on 1351 subjects. 1526 8

Psychometric deviance in personality traits as assessed by the Minnesota Multiphasic Personality Inventory (MMPI; Dahlstrom, Welsh, & Dahlstrom, 1982) was compared between adopted-away, high-risk (HR) offspring of schizophrenic biologic mothers and low-risk (LR) controls. A subsample of the Finnish Adoptive Family Study (Tienari et al., 2000) included 60 HR adoptees and 76 LR control adoptees who were tested by the MMPI before the onset of any psychiatric disorder at the mean age of 24 years. The HR group was found to be distinguishable based on deviant scores on the scales HOS and HYP, indicating emotional unresponsiveness, restricted affectivity, and decreased energy. These may also be considered possible premorbid and prodromal signs of future schizophrenia among the HR adoptees.
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PMID:Psychometric deviance measured by MMPI in adoptees at high risk for schizophrenia and their adoptive controls. 1527 92

"Premonitory symptoms and signs" before the full-blown stage of schizophrenia are recognized as abnormal expressions (signs) and symptoms of "early schizophrenia", as described by Nakayasu (1990). The following conclusions were derived from my examination of the effects of atypical antipsychotics on six patients suffering from 'the premonitory symptoms and signs' in 'the premonitory state of schizophrenia'. 1) Even though hyperventilation, fatigue and a depressive state existed in the foreground at the first medical examination, we suspected 'the premonitory state of schizophrenia', and investigated symptoms of 'early schizophrenia' as described by Nakayasu, in cases in which abnormal expressions such as stiff facial expression and specific tense and perplexed attitude were observed. 2) In cases in which 'the premonitory symptoms and signs' were observed, we introduced treatment with atypical antipsychotics as soon as possible. Hyperventilation and a depressive state, which were considered to be induced by 'the premonitory state of schizophrenia', disappeared as a result of the improvement of 'the premonitory symptoms and signs' by the atypical antipsychotics. 3) Risperidone, perospirone, and olanzapine were effective for so-called "positive early symptoms". Risperidone, which is expected to have an acute effect, was effective in cases in which early intervention was necessary. When a depressive state was secondarily induced by risperidone, a change to perospirone was useful. Furthermore, when risperidone and perospirone were not sufficiently effective, olanzapine improved 'the premonitory symptoms and signs'. 4) In cases in which so-called "negative early symptoms" and a decrease in the energy-potential, such as emotional blunting, were observed, olanzapine induced improvement. 5) In 'the premonitory state of schizophrenia', treatment with atypical antipsychotics should be maintained, for both the improvement of 'the premonitory symptoms and signs' and the prevention of progression to the full-blown stage. The dose and duration of the treatment with antipsychotics should be carefully modified, with consideration for the specificity of the life cycle and life events for each patient. In conclusion, treatment with atypical antipsychotics was useful for both the improvement of 'the premonitory symptoms and signs of schizophrenia' and the prevention of the development of pathogenesis.
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PMID:[Treatment of "the premonitory state of schizophrenia" with atypical antipsychotics]. 1570 May 33

In recent years, research efforts have been directed to better characterize the subjective experience of taking psychotropic drugs. This study investigated the sex difference in the subjective tolerability of antipsychotic drugs. Participants were recruited from patients under the care of psychiatric services serving geographical catchment areas in Croydon (UK), Verona (Italy), Amsterdam (Netherlands), and Leipzig (Germany). Clinically unstable patients with a clinical diagnosis of schizophrenia and a research diagnosis of schizophrenia, established using the Item Group Checklist of the Schedule for Clinical Assessment in Neuropsychiatry, were enrolled. Antipsychotic subjective tolerability was rated by means of the Liverpool University Neuroleptic Side Effect Rating Scale. During the recruitment period, 245 men and 164 women with schizophrenia were recruited. In both sexes, the most frequently reported side effects were difficulty in concentrating, tiredness, and weight gain; these side effects occurred in approximately 50% of men and in up to 70% of women. Extrapyramidal and anticholinergic reactions were reported more often by women, whereas men reported sexual problems more often. After background group differences were controlled for, sex was the strongest determinant of the subjective tolerability of antipsychotic drugs. We therefore conclude that sex differences in the subjective tolerability of antipsychotic drugs should be taken into account in the pharmacological management of patients with schizophrenia. Studies should no longer consider men and women as a homogeneous group, given that the subjective tolerability of antipsychotic drugs substantially differs between sexes.
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PMID:Sex differences in the subjective tolerability of antipsychotic drugs. 1628 31

Mitochondria are intracellular organelles crucial to the production cellular energy. Mitochondrial disease results from a malfunction in this biochemical cascade. These disorders can affect any organ system, producing diverse signs and symptoms, including psychiatric ones. Several authors argue that mitochondrial dysfunction is related to the pathophysiology of bipolar disorder and schizophrenia. Also, the authors retrieved 19 case reports that describe patients with mitochondrial diseases and psychiatric disorders. Most of these patients have psychiatric presentations that preceded the diagnosis of mitochondrial disease. The most common physical findings are fatigue, muscle weakness with or without atrophy, and hearing loss.
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PMID:Review of the literature on major mental disorders in adult patients with mitochondrial diseases. 1638 2

This study examined concerns regarding menopause among women with schizophrenia/schizoaffective disorder (N = 30), women with bipolar disorder (N = 25), and women with major depression (N = 36). The three groups were compared regarding knowledge of menopause, expectations of effect of menopause, and menopause-related quality of life. All women had deficits in fund of knowledge regarding menopause. More than half (53.8%) agreed that they felt more stressed due to menopause or approaching menopause, and 51.6% felt that menopause has had a negative effect on their emotional state. Perceptions of menopause effect on emotional states between the three groups were similar. The top five symptoms experienced by women with serious mental illness were all problems related to psychological issues: feeling depressed (88%, N = 80), feeling anxious (88%, N = 80), feeling tired or worn out (87%, N = 79), feeling a lack of energy (86%, N = 78), and experiencing poor memory (84%, N = 76). Larger-scale studies evaluating the effects of menopause on serious mental illness are needed to clarify how menopause affects illness outcomes in women with serious mental illness.
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PMID:Menopause knowledge and subjective experience among peri- and postmenopausal women with bipolar disorder, schizophrenia and major depression. 1653 34


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