Lurasidone for the treatment of schizophrenia in adult and paediatric populations.

Schizophrenia is a common debilitating disorder characterized by significant impairments in how reality is perceived, combined with behavioural changes. In this review, we describe the lurasidone development programme for adult and paediatric patients. Both the pharmacokinetic and pharmacodynamic characteristics of lurasidone are revisited. In addition, pivotal clinical studies conducted on both adults and children are summarized. Several clinical cases, which demonstrate the role of lurasidone in real-world practice, are also presented. Current clinical guidelines recommend lurasidone as the first-line treatment in the acute and long-term management of schizophrenia in both adult and paediatric populations.

Delirio de formicación. A propósito de un caso / Formication delusion. A case report

Introducción. En el delirio de formicación la persona tiene la creencia irreductible y errónea de estar infectado por parásitos. También pueden producirse las clásicas alucinaciones de formicación, aunque son poco frecuentes. Una disminución del funcionamiento del transportador estriatal de la dopamina sería la causa. Descripción del caso. Varón de 41 años, consumidor de metadona y de 3g/día de "crack". Acude a consultas muy nervioso, refiriendo tener insectos en la piel. Había intentado matar a "esos bichos" quemándose con un cigarrillo. Presentaba importantes lesiones dérmicas secundarias. Se inició tratamiento con pimozida 8mg/día y se derivó a dermatología. Discusión. El delirio de formicación es un cuadro poco frecuente ligado al consumo de cocaína. Puede resolverse de forma espontánea tras el abandono del consumo de cocaína, aunque puede ser necesario el tratamiento farmacológico (AU)

Introduction. In the delusional formication a person has the unshakeable and mistaken belief to be infected by parasites. Also, hallucinations of formication can take place, although they are slightly frequent. A decreased striatal dopamine transporter functioning would be the cause. Case report. Male, 41-year-old, consuming methadone and 3g/day of “crack”. He comes to consultations very nervously assuring to have insects along the skin. He had tried to kill these insects burning them with a cigarette. He had important secondary dermal injuries. Treatment began with pimozida 8mg/day and the patient was sent to dermatology. Discussion. The delirium of formication is a slightly frequent symptom linked to the consumption of cocaine. It can be spontaneously solved once the consumption of cocaine stops; pharmacological treatment can be necessary though (AU)

[Group psychotherapy for prevention of relapses in alcoholism compared to standard outpatient follow-up]. / Terapia grupal en prevención de recaídas del alcoholismo frente a seguimiento ambulatorio habitual.

INTRODUCTION: Relapse Prevention (RP) is the central and most original focus in the treatment of addictions. Several studies support the effectiveness of group therapy in RP. AIMS: To compare group psychotherapy for RP with standard follow-up of alcohol-abuse/ dependence patients. METHOD: Fourteen patients were assigned to the relapse prevention group and another ten patients received the standard outpatient monitoring. Numbers of relapses during the group therapy and one year later were recorded. RESULTS: We found statistically significant differences (CHI(2)=7.95) p=0.019 between the two groups for rates of abstinence and relapse at the twelve-month follow-up. CONCLUSIONS: Group Therapy for Relapse Prevention is effective, easy to apply in the outpatient context and obtains better rates of abstinence than standard outpatient treatment at the one-year follow-up.

Terapia grupal en prevención de recaídas del alcoholismo frente a seguimiento ambulatorio habitual / Group psychotherapy for prevention of relapses in alcoholism compared to standard outpatient follow-up

Introducción: La prevención de recaídas es el punto central y más original de la terapéutica de las adicciones. En este sentido hay estudios que avalan la eficacia de la terapia grupal. Objetivos: comparar la terapia grupal de prevención de recaídas con el seguimiento habitual de pacientes con abuso-dependencia alcohólica. Metodología: se asignaron 14 pacientes al grupo de prevención de recaídas y 10pacientes realizaron el control ambulatorio habitual. Se recogieron el número de recaídas durante el tiempo que duró la terapia grupal y al año. Resultados: Encontramos diferencias estadísticamente significativas (χ2(2)=7,95; p=0,019) en cuanto a las tasas de abstinencia y recaída entre ambos grupos en el seguimiento a 12 meses. Conclusiones: la terapia grupal de prevención de recaída es fácil de aplicar en la consulta externa, eficiente y obtiene mejores tasas de abstinencia en el seguimiento al año, que el tratamiento ambulatorio habitual (AU)

Introduction: Relapse Prevention (RP) is the central and most original focus in the treatment of addictions. Several studies support the effectiveness of group therapy in RP. Aims: To compare group psychotherapy for RP with standard follow-up of alcohol-abuse/dependence patients. Method: Fourteen patients were assigned to the relapse prevention group and another ten patients received the standard outpatient monitoring. Numbers of relapses during the group therapy and one year later were recorded. Results: We found statistically significant differences (χ2(2)=7.95; p=0.019) between the two groups for rates of abstinence and relapse at the twelve-month follow-up. Conclusions: Group Therapy for Relapse Prevention is effective, easy to apply in the outpatient context and obtains better rates of abstinence than standard outpatient treatment at the one-year follow-up (AU)

Reacción exantematosa inducida por ziprasidona / Ziprasidone-induced exanthematous reaction

Introducción: Los fármacos antipsicóticos causan reacciones adversas de tipo cutáneo, aproximadamente, al 5% de los individuos a quienes se prescriben. Descripción del Caso: Paciente de 44 años diagnosticada de trastorno bipolar tipo I, que ingresó en el hospital por presentar descompensación de su psicopatología. Tres días después del incremento de ziprasidona a 120 mg/día, presentó lesiones dérmicas maculopapulosas en el tronco y las extremidades superiores, de forma simétrica, que se acompañaban de intenso prurito y febrícula de 37,5 °C. Se suspendió la ziprasidona y tuvo una recuperación completa de las lesiones tras 5 días. Discusión: Ya que las reacciones adversas de tipo cutáneo producidas por psicofármacos son comunes y potencialmente serias, el psiquiatra debe estar familiarizado con ellas (AU)

Introduction: Antipsychotic agents are known to cause adverse cutaneous reactions in approximately 5% of individuals prescribed these drugs. Case report: The patient was 44-year-old woman diagnosed with bipolar disorder type I, who was admitted to hospital for decompensation of her psychopathology. Three days after the dose of ziprasidone was increased to 120 mg/day, the patient developed macules and papules on the trunk and symmetrically distributed on the upper limbs, accompanied by intense pruritus. Her temperature was 37.5 °C. Ziprasidone was suspended, with complete disappearance of the lesions after 5 days. Discussion: Since adverse cutaneous reactions to psychotropic medications are common and potentially serious, psychiatrists should be well versed in these events (AU)