Second-generation antipsychotic use in schizophrenia and associated weight gain: a critical review and meta-analysis of behavioral and pharmacologic treatments.

Background: Weight gain in schizophrenia, particularly secondary to second-generation antipsychotic (SGA) use, is a common adverse effect and often is associated with significant physical and psychological morbidity.

Methods: We performed a critical literature review of all controlled clinical trials for pharmacologic and/or behavioral management of SGA-induced weight gain in schizophrenia patients by searching PubMed and Google Scholar. A meta-analysis was performed to estimate and compare weight changes for various medications and behavioral interventions.

Psychotropics and sexual dysfunction: the evidence and treatments.

Sexual dysfunction is common in the general population and even more common in the mentally or medically ill. Because mentally ill patients often receive psychotropics, many of which affect sexual functioning, a patient's pre-existing sexual difficulties are often compounded, and these adverse effects may contribute to psychological difficulties or medication discontinuation. The effects of antidepressants, antipsychotics, mood stabilizers and anxiolytics on sexual functioning are critically reviewed.

Predictors of psychological symptoms 1 year after traumatic brain injury: a population-based, epidemiological study.

Objective: To examine self-reported psychological symptoms 1 year after traumatic brain injury (TBI) in a population-based sample.

Participants: There were 1560 adults who had sustained TBI.

Design: A telephone survey with questions about recent mood and anxiety symptoms, and diagnoses since TBI.

Guidelines for the pharmacologic treatment of neurobehavioral sequelae of traumatic brain injury.

There is currently a lack of evidence-based guidelines to guide the pharmacological treatment of neurobehavioral problems that commonly occur after traumatic brain injury (TBI). It was our objective to review the current literature on the pharmacological treatment of neurobehavioral problems after traumatic brain injury in three key areas: aggression, cognitive disorders, and affective disorders/anxiety/ psychosis. Three panels of leading researchers in the field of brain injury were formed to review the current literature on pharmacological treatment for TBI sequelae in the topic areas of affective/anxiety/ psychotic disorders, cognitive disorders, and aggression.

Patterns of alcohol use 1 year after traumatic brain injury: a population-based, epidemiological study.

This study delineated patterns of alcohol use 1 year after traumatic brain injury (TBI) in a large, population-based, epidemiological, nonclinical sample, and identified predictors of heavy alcohol use in these individuals. Participants were 1,606 adults identified by review of a South Carolina statewide hospital discharge data set, on the basis of satisfying the Centers for Disease Control case definition of TBI, and were interviewed by telephone 1 year after TBI-related discharge. Alcohol use in the month prior to interview was classified according to categories from the Quantity-Frequency-Variability Index; heavy drinking was defined as nearly daily use with > or = 5 drinks at least occasionally, or at least three occasions with > or = 5 drinks.

Does comorbid anxiety or depression affect clinical outcomes in patients with post-traumatic stress disorder and alcohol use disorders?

Post-traumatic stress disorder (PTSD) is commonly comorbid with other psychiatric disorders, including substance use disorders. In spite of this, pharmacologic treatment trials for PTSD often exclude individuals with significant psychiatric comorbidity. This study is a post hoc analysis of a 12-week double-blind placebo-controlled trial investigating sertraline in the treatment of patients with comorbid PTSD and an alcohol use disorder.

Antidepressant-related erectile dysfunction: management via avoidance, switching antidepressants, antidotes, and adaptation.

The ideal antidepressant would control depression with no adverse effect on sexual function. Erectile dysfunction and other sexual dysfunction associated with antidepressant medication treatment are problems with many antidepressants and can lead to patient dissatisfaction and decreased compliance with treatment. A computerized MEDLINE search (English language, 1966-2003) was performed using the terms antidepressive agents, erectile dysfunction, and sexual dysfunction.

Psychosis and delirium following metabolife use.

Weight gain is a well-known complication of antipsychotic therapy, especially when using newer atypical antipsychotic agents. In addition to the risk of medical comorbidities associated with weight gain, such as diabetes mellitus and cardiovascular disease, a further risk of antipsychotic-induced weight gain is that patients may resort to over-the-counter preparations to aid in weight loss. We report on a case in which a patient with schizophrenia began using Metabolife, an herbal preparation containing ephedra, for weight reduction and subsequently developed an exacerbation of his psychosis with superimposed delirium.