Perceived Awareness of Clozapine associated with Socio- Demographic status, clinical, and side effect profile among patients from Mental Health Hospital, Taif, Saudi Arabia

Background: The main objective was to investigate the Socio-demographic, clinical, and side effect profile of patients on clozapine from Mental Health Hospital, Taif, Saudi Arabia. This article reports on an observational study. Clozapine is a second-generation atypical antipsychotic used as the drug of choice for the treatment resistant psychosis. It is supposed to be a baseline study from which we will get and understand rate of clinical, and side effect profile of the clozapine taking patients. Physicians, particularly psychiatrists are not only ignoring but also not aware, alert, so they always need to be watchful to the fatality of the drug, and take appropriate therapeutic measures. The aim was to study the socio-demographic status, clinical profile, comorbidity, side effects and outcome of patients treated with clozapine. Methodology: We reviewed all the indoor psychiatric patients of Mental Health Hospital, Taif, Saudi Arabia, from the period of one year between January 2021 to January 2022 (N=29). Our study design focused on prospective and observational studies. Descriptive statistical analysis was explored, and presented as frequencies, and percentages. We also determined crude rates for all adverse outcomes of clozapine. Results: We did a nearly mean follow-up of one year. The majority of patients were male (n=26; 89.65%), with a maximum being unmarried (n=16; 55.17%). Most patients belong to nuclear families due to cultural restrictions in this country (n=23; 79.31%). Among the literacy rate illiterate were (n=2; 6.89%, and unemployed (n=23; 79.31%). Among the study populations, the majority of respondents were found to have treatment-resistant schizophrenia (n=18; 62.06%), and around 79.31% of patients took more than two antipsychotics in adequate doses. Among side effect profiles most of the patients suffered hyper-salivation (n=19; 65.51%), sedation (n=12; 41.37%), and rarely suffered from agranulocytosis. Conclusion: Socio-demographic, clinical, and side effect profiles were the significant indicators of clozapine. Clozapine has been used for treatment-resistant psychosis, but due to fatal side effect profile we used it cautiously. In our study, we found that myocarditis, hematemesis, and leukocytosis, and neutropenia are fatal side effects of clozapine. We also found hyponatremia-induced seizure. The prevalence of blood dyscrasias in our study is rarely seen. Hyper-salivation is the most common side effect reported. Majority of the patients in our study were male, and treatment resistant Schizophrenia was the most common diagnosis. Myocarditis is life-threatening side effect seen in our study

A study on haloperidol and risperidone induced metabolic derangements in patients with newly diagnosed schizophrenia

Background: The occurrence of metabolic abnormalities in schizophrenic patients has been increased with the rampant use of second-generation antipsychotics. The aim and objective of this study is to compare the metabolic derangements induced by a typical antipsychotic: haloperidol and an atypical antipsychotic, risperidone in patients with newly diagnosed schizophrenia in a tertiary care hospital.Methods: Out of 60 newly diagnosed schizophrenic patients, 30 patients received tablet haloperidol and the remaining 30 patients received tablet risperidone orally. The anthropometric measurements like height, weight, waist circumference was measured and blood investigations like fasting blood glucose level and fasting lipid profile were taken at baseline and at the end of 3 and 6 months of drug therapy. The metabolic derangements induced by the two antipsychotics were compared and analyzed at end of 3rd and 6th month using SPSS software version 16.Results: At the end of 6th month statistically significant differences (p<0.05) were observed in weight, waist circumference, fasting blood sugar, fasting triglyceride and high-density lipoprotein level between the haloperidol and risperidone group on following the International Diabetic Federation (IDF) criteria of metabolic syndrome. Risperidone caused metabolic abnormalities in 13.3%, 4 patients whereas none of the patients in haloperidol group developed metabolic syndrome.Conclusions: Hence it is concluded that the atypical antipsychotic risperidone has been associated with an increased risk of causing metabolic abnormalities than the typical antipsychotic haloperidol. Regular and periodic monitoring of the anthropometric and metabolic parameters in schizophrenic patients on antipsychotics especially the atypical antipsychotics is mandatory to prevent further complications.

Efectos secundarios metabólicos de los antipsicóticos de segunda generación / Metabolic side effects of second-generation antipsychotics

Resumen: Los antipsicóticos se prescriben ampliamente para el tratamiento de un gran número de problemas neuropsiquiátricos. Los antipsicóticos se dividen en dos clases de acuerdo con su estructura química, los típicos o de primera generación y los atípicos o de segunda generación. Estos últimos tienen mayores beneficios que los primeros porque producen menos efectos secundarios extrapiramidales; sin embargo, diversos estudios efectuados en humanos y en animales han relacionado su administración con efectos secundarios metabólicos, como obesidad, aumento de peso, diabetes, dislipidemias, síndrome metabólico y resistencia a la insulina. Debido a estos efectos se han establecido guías clínicas para el control y la vigilancia de los pacientes con algún tratamiento con este tipo de fármacos. El objetivo de este artículo es revisar algunos efectos secundarios metabólicos producidos por los antipsicóticos de segunda generación, así como su posible mecanismo de acción y el seguimiento o control metabólico que los pacientes en tratamiento con estos fármacos deben llevar. La búsqueda de los artículos se realizaron en las bases de datos PubMed, EBSCOHOST, DynaMed e IntraMed.

Abstract: Antipsychotics are widely prescribed to treat a large number of neuropsychiatric problems. Antipsychotics are divided in two classes according to their chemical structure, typical or first generation and the atypical or second generation. The second-generation antipsychotics have greater benefits because they produce less extrapyramidal side effects; however, several studies in both humans and animals have related their administration to metabolic side effects, such as obesity, weight gain, diabetes, dyslipidemia, metabolic syndrome and insulin resistance. Because of the effects, clinical guidelines for the control and monitoring of patients with a treatment with these drugs have been established. The aim of this paper is to review some metabolic side effects produced by the second-generation antipsychotics and its possible mechanism of action, as well as the metabolic control or monitoring that patients treated with these drugs should have. The research of the articles was made in the databases: PubMed, EBSCOHOST, DynaMed and IntraMed.

Relation between hyponatremia and alteration in gross metabolic parameters after atypical antipsychotic therapy

Background: Weight gain and hyponatremia which is dilutional in nature, has been well known adverse effects associated with use of atypical antipsychotic medication but the plausible impact of dilutional hyponatremia on weight gain has not been explored.Methods: One hundred and three patients more than 18 years of age of either gender who were prescribed, olanzapine or risperidone, were tested for serum electrolytes (Na+ and K+) and gross metabolic parameters (weight and waist circumference) were measured for baseline and post drug testing.Results: Most common age group was 30-39 years of age in the patient study sample (n=103) with 38 (36.90%) patients were females while rest 63 (63.10%) were males. There was no significant association between serum sodium levels and weight gain was observed (p >0.05). It was observed that in olanzapine group 64% of the studied cases had weight gain whereas in risperidone group only 20.8% reported weight gain (p <0.001). There was significant association between olanzapine and increase in waist circumference over risperidone, irrespective to serum sodium status (x2=0.0148, p >0.05).Conclusions: Olanzapine was primarily responsible for weight gain and increase in waist circumference over risperidone. These gross metabolic parameters were not influenced by hyponatremia.

Research progress of role of Pi3k/Akt pathway in mechanism of atypical antipsychotic drugs / 上海交通大学学报（医学版）

The alterations of Pi3k/Akt pathway may be critical in the pathogenesis of schizophrenia. Furthermore, atypical antipsychotic drugs can modify Pi3k/Akt pathway, which have been received wide attention. This review mainly focused on four aspects, i.e. metabolic syndrome, changes in immune function, cognitive impairment and neuroprotective effect, and summarized the research progress of role of Pi3k/Akt pathway in the mechanism of atypical antipsychotic drugs.

Comparison of Hematologic Variability between Clozapine Monotherapy and Augmentation Therapy with Atypical Antipsychotics for Schizophrenia: Results from a 6-Month Retrospective Follow-Up Study / 대한정신분열병학회지

OBJECTIVES: Clozapine is an antipsychotic agent commonly prescribed in patients with treatment-resistant schizophrenia. A drawback of using clozapine is risk of hematologic side effects ranging from mild neutropenia to fatal agranulocytosis. In clinical settings, other atypical antipsychotic agents are frequently combined with clozapine because some treatment-resistant patients would not respond to clozapine alone. Unfortunately, other atypical antipsychotics may also cause hematologic side effects, and the combination therapy might aggravate the possible neutropenic side effects. The purpose of this study was to investigate the difference in the incidence of hematologic side effects between clozapine monotherapy and augmentation therapy. METHODS: We retrospectively reviewed the medical records of 114 patients who were diagnosed with schizophrenia and being prescribed with clozapine in a single university hospital. White blood cell count (WBC) and absolute neutrophil count (ANC) were identified every 1 month in clozapine monotherapy group and clozapine-atypical antipsychotics augmentation therapy group. RESULTS: Compared with clozapine monotherapy group, augmentation therapy group showed no significant differences in WBC and ANC for the first 6 months of combination. Amisulpride augmentation showed temporary increases in WBC and ANC, especially compared with paliperidone augmentation. CONCLUSION: Augmentation of amisulpride to clozapine might be associated with temporary increases in WBC and ANC during the first 3 months of combination. Further investigations should be carried out to clarify the clinical significance of our findings.

Comparison of Hematologic Variability between Clozapine Monotherapy and Augmentation Therapy with Atypical Antipsychotics for Schizophrenia: Results from a 6-Month Retrospective Follow-Up Study / 대한정신분열병학회지

OBJECTIVES: Clozapine is an antipsychotic agent commonly prescribed in patients with treatment-resistant schizophrenia. A drawback of using clozapine is risk of hematologic side effects ranging from mild neutropenia to fatal agranulocytosis. In clinical settings, other atypical antipsychotic agents are frequently combined with clozapine because some treatment-resistant patients would not respond to clozapine alone. Unfortunately, other atypical antipsychotics may also cause hematologic side effects, and the combination therapy might aggravate the possible neutropenic side effects. The purpose of this study was to investigate the difference in the incidence of hematologic side effects between clozapine monotherapy and augmentation therapy. METHODS: We retrospectively reviewed the medical records of 114 patients who were diagnosed with schizophrenia and being prescribed with clozapine in a single university hospital. White blood cell count (WBC) and absolute neutrophil count (ANC) were identified every 1 month in clozapine monotherapy group and clozapine-atypical antipsychotics augmentation therapy group. RESULTS: Compared with clozapine monotherapy group, augmentation therapy group showed no significant differences in WBC and ANC for the first 6 months of combination. Amisulpride augmentation showed temporary increases in WBC and ANC, especially compared with paliperidone augmentation. CONCLUSION: Augmentation of amisulpride to clozapine might be associated with temporary increases in WBC and ANC during the first 3 months of combination. Further investigations should be carried out to clarify the clinical significance of our findings.

Association between weight gain induced by atypical antipsychotic and the polymorphisms of MC4R gene rs12970134 / 中国基层医药

Objective To determine the association between weight gain induced by atypical antipsychotic and the polymorphisms of MC4R gene rs12970134.Methods 62 patients who had weight gain more than 7% of their pre -drug body weight were selected as study group,and 62 patients who had weight gain less than 7% of their pre -drug body weight were selected as control group.The polymorphism of MC4R gene rs12970134 was analyzed by using polymerase chain reaction and directly sequencing technology.Results There were no significant differences in the frequency of MC4R gene rs12970134 genotypes and alleles between the two groups(χ2 =0.648,P =0.723;χ2 =0.679,P =0.410).While after the treatment with atypical antipsychotic,the weight gain degree in patients with GG genotypes was less than patients with GA /AA genotypes[(22.18 ±0.33)kg/m2 vs.(23.53 ±0.58)kg/m2 ](t =-2.167,P =0.032).Conclusion The polymorphisms of MC4R gene rs12970134 maybe affect the weight gain degree in patients after treatment with antipsychotic.

A Study on Changes of Metabolic Parameters with Antipsychotic Treatment in Schizophrenic Patients : 1 Year Prospective Natualistic Study / 대한정신분열병학회지

OBJECTIVES: Schizophrenia patients are known to be more prone to metabolic disease than normal people. This study aimed to identify the changes in metabolic parameters of schizophrenia patients using atypical antipsychotic drugs for 1 year. METHODS: A total of 200 schizophrenia patients were recruited and categorized into the aripiprazole-treatment group and control group taking 5 atypical antipsychotic drugs. Comparative analysis were between groups. The prescriptions of psychotropic drugs were collected by a review of medical records. Blood was collected after fasting for 12 hours at the starting point of treatment and the 12th month, and patient medical records were evaluated for basici nformation and treatment history. Physical measurement, the prevalence of metabolic syndrome and metabolic parameters were studied using ATP-III diagnostic criteria. RESULTS: From the study, the aripiprazole-treatment group had a mean weight increase of 0.6 kg and the control group had a mean weight increase of 6.5 kg at the 1 year follow-up, showing a significant difference between the two groups. There were also significant differences between the two groups in waist size, systolic and diastolic blood pressure, fasting blood sugar, total cholesterol, triglyceride, HDL-choleseterol and prolactin level. Along with meaningful improvement of the symptoms, aripiprazole-treatment group showed less effect on in abdominal obesity, diabetes, blood pressure, cholesterol and prolactin than other atypical antipsychotic drugs. CONCLUSION: Therapeutic intervention such as diagnosis, treatment, weight management and diet improvement is necessary for schizophrenia patients. Psychiatric symptoms as well as internal meicine-related problems such as metabolic disease need to be addressed in case management.

Pharmacotherapy of Bipolar Disorder with Quetiapine: A Recent Literature Review and an Update

Bipolar disorder is a chronic, recurrent condition with the usual onset during adolescence or early adulthood. In the Diagnostic and Statistical Manual of Mental Disorders 5th edition, it is conceptualized as a spectrum disorder usually associated with such comorbidities as anxiety disorders and substance use disorders. It is a relatively prevalent condition often complicated by mixed episodes, rapid cycling, subsyndromal symptoms, and treatment refractoriness. In spite of carrying substantial morbidity and mortality, effective treatments are few and far between and conventional mood stabilizers are often unsuccessful in controlling the various manifestations of the disorder. In this scenario, second generation antipsychotics are emerging as treatments with valid efficacy in all phases of bipolar disorder. Quetiapine is a versatile atypical antipsychotic which was first approved for the treatment of schizophrenia, but latter on the basis of controlled studies earned United States Food and Drug Administration's approval for acute as well as maintenance treatment of this difficult to treat condition. In this review, recently published studies in the last 10 years were examined to update the knowledge about the efficacy and safety of quetiapine in the treatment of bipolar disorder. The medication's clinical pharmacology was first considered followed by a literature review summarizing its uses in bipolar disorder. The conclusion was that quetiapine was efficacious in manic, mixed and depressive episodes and as a maintenance agent with a good tolerability profile.

Aripiprazole in the Treatment of Refractory Mood Disorders: A Case Series

Major depressive disorder and bipolar disorders are among the commonest neuropsychiatric conditions, affecting persons of both sexes which belong to all age groups. Comorbidity is the rule rather than the exception; anxiety spectrum disorders, somatoform disorders, eating disorders and substance use disorders frequently co-exist with mood disorders. Catatonia is a serious complication of the latter and every patient with a severe affective exacerbation should be assessed for the presence of catatonic signs and symptoms. In a significant minority of patients, symptoms show treatment resistance; many patients experience severe hopelessness and suicidal ideation, causing high rates of morbidity and mortality in afflicted individuals. Pharmacological management is challenging and currently available psychotropic agents often fall short of inducing remission. Second generation antipsychotics have been shown in a number of studies as having an antidepressant and mood stabilizing effect. Aripiprazole is a novel antipsychotic which is being increasingly used in difficult to treat mood disorders patients. Several controlled and uncontrolled studies have shown the efficacy and safety of this medication in subjects of all ages. Here a case series of three patients is presented who suffered from refractory mood disorders but responded to aripiprazole with complete remission of affective symptoms.

Olanzapine induced hyperprolactinemia.

Olanzapine, a second generation antipsychotic is widely used for the treatment of schizophrenia and bipolar disorders. Though olanzapine is an efficacious antipsychotic it has been associated with many adverse effects like weight gain, hyperlipidemia, diabetes mellitus, etc necessitating its discontinuation. Here, we present two cases of hyperprolactinemia induced by olanzapine.

Síntomas de discontinuación luego de suspensión abrupta de olanzapina / Discontinuation symptoms following olanzapine abrupt withdrawal

Extended use of atypical neuroleptics in clinical practice, may be explained by their effectiveness as antipsychotics and also with recent approvals for therapeutic benefits of this drugs beyond psychotic disorders. Receptor adaptation mechanisms rises critical issues about treatment discontinuation strategies. Clinical data of two patients who have required the use of atypical antipsychotics are discussed. In both cases, abrupt discontinuation of the drug occurred followed by the emergence of extrapyramidal symptoms. Adaptation mechanisms in synaptic structures would be responsible for this phenomena and the subsequent amelioration of this extrapyramidal symptoms when initial treatment is replaced. The authors concluded that atypical antipsychotics, as other psychotropic agents shouldn't be abruptly discontinued even when they are replaced by other drugs from the same family.

El uso de los antipsicóticos atípicos ha ido aumentando con el tiempo entre otras cosas, por el hecho de que se están usando no sólo para los cuadros psicóticos sino que también para otras patologías. Como con otros fármacos que actúan a nivel de receptores deben considerarse los mecanismos de adaptación receptorial que se producen con su uso. Lo anterior es de suma importancia cuando pensamos en la discontinuación del tratamiento y en sus formas de hacerlo. En este trabajo presentamos dos casos clínicos de pacientes que han requerido el uso de antipsicóticos atípicos. En ambos casos se ha realizado una suspensión brusca del fármaco lo que ha generado la aparición de síntomas extrapiramidales, que en nuestra opinión, son explicados por mecanismos de adaptación a nivel sináptico y que han disminuido con el reinicio del tratamiento inicial. Debemos tener presente que estos fármacos no deben ser discontinuados en forma súbita aun cuando sean remplazados por otros de la misma familia.

Efficacy and Safety of Paliperidone Extended Release in Schizophrenia Patients Requiring a Switch in Antipsychotic Medication by Switching Previous Antipsychotics to Paliperidone Extended Release / 대한정신약물학회지

OBJECTIVE: This study aimed to evaluate the clinical efficacy, safety, and tolerability of paliperidone extended release (ER) in patients with schizophrenia by switching previous antipsychotics to paliperidone ER. METHODS: An open-label, 24 weeks, prospective, non-comparative, multi-center study evaluated total 387 patients with schizophrenia requiring a switch in antipsychotic medication due to suboptimal efficacy, intolerability, and non-compliance. Patients were switched to flexible-dose trial of paliperidone ER (3-12 mg/day). Efficacy was measured by Krawiecka Scale, Clinical Global Impression-Schizophrenia-Severity (CGI-SCH-S), Clinical Global Impression-Schizophrenia-Improvement (CGI-SCH-I), sleep visual analog scale (VAS), and Personal and Social Performance Scale (PSP). Safety assessments included adverse events (AEs), evaluation of extrapyramidal symptoms (EPS) using the Drug Induced Extrapyramidal Symptoms Scale (DIEPSS), and laboratory tests. RESULTS: Data from a total of 321 subjects who took the paliperidone ER and had at least one follow-up assessment without a major protocol violation were analyzed. Switching to paliperidone ER led to a significant improvement in the Krawiecka, CGI-SCH-S, CGI-SCH-I, PSP, and DIEPSS scales. However, serum prolactin levels and metabolic parameters including body weight and waist circumference were significantly increased. Insomnia was the most common adverse event. CONCLUSION: This study suggested that patients with schizophrenia who showed insufficient response or intolerance to other previous antipsychotics can be switched to paliperidone ER, with efficacy, safety, and tolerability.

A comparative study between long-acting risperidone microsphere injection for treatment of patients with schizophrenia / 中华行为医学与脑科学杂志

Objective To investigate clinical efficacy and side effects of long-acting risperidone microsphere injection for treatment of patients with schizophrenia. Methods A total of 82 patients with schizophrenia were randomly divided into two groups,study group with long-acting risperidone microsphere injection and control group with atypical antipsychotics treatment for 24 weeks. The Positive and Negative Syndrome Scale (PANSS),The Personal and Social Performance (PSP) and Treatment Emergent Symptoms Scale (TESS) were used to evaluate efficacy and adverse effects of treatment at the end of 1st ,2nd,4th, 12nd and 24th week. Results The therapeutic efficacy in control group was similar to that in study group,and there was no significant difference between the two groups (P＞ 0.05 ). But the therapeutic efficacy in study group was better than that in control group at the end of the 4nd week (P＜0.05 ) , and study group was more likely to improve social function(P ＜ 0. 05 ). Incidence of adverse effects in study group was lower than that in control group , but the difference was not significant (P ＞0.05 ). The incidence of akathisia symptom in study group was higher than that in control group,but the difference was not significant (P＞0.05). The incidence of drowsiness symptom in study group was significantly lower than that in control group(P＜0.05 ). Conclusion Long-acting risperidone microsphere injection is as effective as atypical antipsychotics for treatment of patients with schizophrenia, but it has better efficacy in improving social function of the schizophrenia with lower side effects.

Antipsicóticos atípicos e comportamento suicida em pacientes esquizofrênicos ou esquizoafetivos: [revisão] / Atypical antipsychotics and suicidal behavior in esquizophrenic or schizo-affective patients: [review]

CONTEXTO: Os estudos a respeito da ação dos antipsicóticos atípicos no comportamento suicida são controversos e pouco explorados. OBJETIVOS: Análise discursiva da ação dos antipsicóticos atípicos no comportamento suicida de pacientes esquizofrênicos ou esquizoafetivos. MÉTODOS: Revisão de artigos nas bases de dados MEDLINE, LILACS e da Biblioteca Cochrane, entre o período de 1964 e 2009, usando as palavras-chave: "suicidal behavior" e/ou "suicide" e "atypical antipsychotics" e/ou "antipsychotics" e/ou "clozapine". RESULTADOS: As únicas evidências significativas positivas apontam para a clozapina, que apresenta uma relevância superior aos outros antipsicóticos de segunda geração na redução das taxas de autoextermínio. CONCLUSÕES: A clozapina é o único fármaco que pode alterar o comportamento suicida. Esse efeito não está associado à melhora clínica dos pacientes. Ela é a única droga aprovada pelo Food and Drug Administration (FDA) para prevenir suicídio em pacientes esquizofrênicos, mas os critérios para esse fim são incertos.

BACKGROUND: The literature concerning the net effect of atypical antipsychotic medication on suicidality is not consistent. OBJECTIVES: The empirical literature relating to the efficacy of pharmacological intervention with atypical antipsychotics in esquizophrenic or schizo-affective patients is comprehensively reviewed. METHODS: MEDLINE, LILACS and Cochrane Library were used to search for articles from 1964 to 2009 using these key-words: "suicidal behavior" e/ou "suicide" e "atypical antipsychotics" e/ou "antipsychotics" e/ou "clozapine". RESULTS: The strongest and perhaps unique evidence has been shown for clozapine, which seems to have a clinically relevant advantage over other second-generation antipsychotics for reducing suicidality temptation. DISCUSSION: Clozapine is the unique medication that modulates suicidal behavior. Its action is unknown but is not related do clinical improvement. It is the unique drug approved by Food and Drug Administration (FDA) to prevent suicide in esquizophrenic patients but the criteria for his use is uncertain.

The Effect of Antipsychotic Drug Treatment on Serum VEGF, sVEGFR-1, and sVEGFR-2 Level in Schizophrenia: A Preliminary Study

OBJECTIVES: Vascular endothelial growth factor(VEGF), one of potent cytokines, and its receptors were related with various biological functions and pathological conditions. The purpose of this study was to investigate the changes of serum level of free VEGF, soluble VEGFR-1, and soluble VEGFR-2 after treatment with atypical antipsychotic drug in schizophrenia. METHOD: The schizophrenic patients were diagnosed with DSM-IV and were prospectively followed up for 4 and 8 weeks. Thirteen schizophrenic patients were evaluated their clinical assessment with serum levels of free VEGF, sVEGFR-1, sVEGFR-2, and positive and negative symptom scale(PANSS) at baseline, 4 weeks, and 8 weeks after treatment with atypical antipsychotic drug. Thirteen normal control subjects were recruited and matched with the patient group by age and sex. RESULT: The serum level of free VEGF(295.2+/-43.7pg/ml)and sVEGFR-2(8259+/-336.7) at baseline(before treatment) in schizophrenic patients were not significantly different, compared with the control group(199.0+/-28.8 and 8481+/-371.9) respectively. However, the serum level of sVEGFR-1(86.2+/-10.3, p<0.05) was significantly increased in the schizophrenic patients compared with the control group(59.0+/-6.4). After treatment with antipsychotic drug, the serum levels of free VEGF at 4 weeks(338.9+/-56.5) and 8 weeks(309.5+/-58.7) were not significantly, different compared with baseline. But the serum levels of sVEGFR-1 was significantly decreased at 8 weeks(57.3+/-6.3, p<0.05) after antipsychotic drug treatment. The serum levels of sVEGFR-2 were decreased at 4 weeks(7761+/-403.0, p<0.05) and 8 weeks(7435+/-333.5, p<0.05) compared with baseline. CONCLUSION: The decreased serum level of sVEGFR-1 and sVEGFR-2 might be affected by dopaminergic system which was influenced by antipsychotic drug.

Modulation of Dopamine D2 Receptors as a Basis of Antipsychotic Action / 대한정신약물학회지

As comparing to typical antipsychotics, atypical antipsychotics have several characters such as no causing catalepsy in animal models or extrapyramidal side effects in schizophrenia patients, no or transient prolactin elevation (except risperidone, amisulpride), effects on negative symptoms, mood and affective symptoms, and efficacy in refractory schizophrenia. In views of the results of several studies so far achieved, the action at the dopamine D2/3 receptors, is by itself, sufficient to provide the contemporary kind of atypical antipsychotic activity. This review will attempt to address the modulation of dopamine D2 receptors as a basis of atypical antipsychotic action by looking over dopamine receptor occupancy, differential effects at the striatal versus extrastriatal dopamine D2 receptor, D2 receptor affinity and Koff consideration, effects for psychotic symptoms.

Clinical Effects of Amisulpride, A Pure Dopaminergic Atypical Antipsychotic / 대한정신약물학회지

Amisulpride is a highly selective D2 and D3 dopaminergic receptor blocker with no other interactions with central nervous system receptors. Amisulpride shows a robust efficacy in controlling the acute positive symptoms of schizophrenia. Compared with conventional antipsychotics, amisulpride, like other atypical antipsychotics, has a very low propensity to induce extrapyramidal side effects. In the long-term studies, a stable therapeutic response on both positive and negative symptoms is observed without significant tardive dyskinesia. Several long-term studies also have confirmed. In this regard, amisulpiride is classified into atypical antipsychotics. Interestingly, amisulpride has proved to be effective in some populations of schizophrenic patients with mainly negative symptom.

Prevalence of hyperglycemia among patients taking atypical antipsychotics seen at the UP-Philippine General Hospital

OBJECTIVE: To determine the prevalence of hyperglycemia among patients taking anti-psychotics in a hospital setting. METHODOLOGY: Twenty-one patients seen at the out patient department and admitted to the in-patient service of UP-PGH, who were taking atypical anti-psychotics such as amisulpiride, clozapine, olanzapine, quetiapine, and risperidone, were screened for hyperglycemia using serum fasting glucose. RESULTS: None of the twenty-one patients taking any of the atypical anti-psychotics tested positive for hyperglycemia. CONCLUSION: Hyperglycemia was not prevalent among this sample of patients taking atypical anti-psychotics.