The Management of Posttraumatic Stress Disorder and Acute Stress Disorder: Synopsis of the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline.

Description: The U.S. Department of Veterans Affairs (VA) and Department of Defense (DoD) worked together to revise the 2017 VA/DoD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder.

Recycling N-acetylcysteine: A review of evidence for adjunctive therapy in schizophrenia.

Introduction: All symptoms in schizophrenia may impact functioning. Although Food and Drug Administration-approved medications typically benefit positive symptoms, negative symptoms are generally refractory to medication interventions. N-acetylcysteine's (NAC) influence on glutamatergic neurotransmission has been established.

Evaluation of adherence in patients prescribed long-acting injectable antipsychotics: A comparison of biweekly versus monthly administered neuroleptics.

Background: Long-acting injectable antipsychotics (LAIAs) have been developed to decrease medication nonadherence. LAIAs are usually given biweekly or monthly, with the exception of new 3-month and 6-week formulations. There has been no known evaluation regarding whether the frequency of LAIA formulation affects adherence.

Lurasidone: an atypical antipsychotic for schizophrenia.

Objective: To provide a clinical overview of the antipsychotic lurasidone.

Data Sources: Articles were identified by searching the MEDLINE, PubMed, Cochrane Library, and EBSCO databases (through February 2012) using the key word lurasidone. The manufacturer provided information on unpublished Phase 2 and 3 trials.

Dalfampridine: a medication to improve walking in patients with multiple sclerosis.

Objective: To review the pharmacology, pharmacokinetics, efficacy, and safety of dalfampridine.

Data Sources: A search of PubMed (1966-March 2012) was conducted using the words dalfampridine and Ampyra. Bibliographies of retrieved articles were reviewed to identify additional references.

Asenapine: a new antipsychotic option.

Asenapine is a new psychopharmacologic agent approved for the acute and maintenance treatment of schizophrenia and the acute and maintenance treatment of manic and mixed episodes associated with bipolar I disorder. The efficacy of asenapine in treating schizophrenia was evaluated in four 6-week studies in which placebo and active controls (risperidone, olanzapine, and haloperidol) were used. Two 3-week placebo-controlled trials examined the efficacy of asenapine and active control (olanzapine) in the treatment of bipolar I disorder.

Pilot study to assess subjective and objective reporting of potential adverse drug reactions in older versus younger HIV-infected patients using antiretroviral therapy.

Limited data exist on tolerability of antiretroviral therapy (ART) in older HIV-infected patients compared to their younger counterparts. There is also concern for overlap of ART toxicities with concomitant conditions potentially leading to an increased burden of ART-related adverse drug reactions (ADRs). A prospective, descriptive-comparative study was conducted to compare incidence and severity of ADRs secondary to ART in older (≥ 50 years) versus younger (<50 years) HIV-infected patients.

Practical considerations for carbamazepine use in bipolar disorder.

Carbamazepine (CBZ) has a long history of successful use in epilepsy and, therefore, has a safety profile that is well characterised. Additionally, an extended-release formulation of CBZ (CBZ-ERC; Equetro, Shire US) has recently been approved for use in bipolar disorder. The most frequent adverse events associated with CBZ are somnolence, fatigue, dizziness and headache.

Risperidone in the treatment of bipolar mania.

Atypical antipsychotic medications have assumed growing importance for the treatment of bipolar disorder, an illness that affects approximately 1.2%-3.7% of the general population in a given year.

Catatonic schizophrenia and the use of memantine.

Objective: To report a case of catatonic schizophrenia treated with memantine that resulted in a rapid reduction of catatonic symptoms.

Case Summary: A 68-year-old male with catatonic schizophrenia presented with bizarre and catatonic behavior manifested by mutism, waxy flexibility, immobility, staring, nonresponsiveness to verbal commands, grimacing, rigidity, and posturing. During the course of his hospitalization, he was treated with memantine up to 10 mg/day.

Reassessing carbamazepine in the treatment of bipolar disorder: clinical implications of new data.

This monograph summarizes the proceedings of a roundtable meeting convened to discuss the role of carbamazepine in the treatment of bipolar disorder, in light of new data and the recent indication of carbamazepine extended-release capsules (CBZ ERC) for use in the treatment of acute manic and mixed episodes. Two lectures were presented, followed by a panel discussion among all 6 participants. A summary of the two pivotal trials of CBZ ERC and their pooled data along with other relevant data is presented first.

Risperidone for bipolar disorders.

Atypical antipsychotic medications are a relatively new, increasingly prominent component of the treatment armamentarium for bipolar disorder -- a development that provides more options for potentially improved outcomes for patients and families affected by bipolar disorder. The US Food and Drug Administration-approved bipolar indications for risperidone include monotherapy for the short-term treatment of acute manic or mixed episodes associated with bipolar I disorder and combination therapy with lithium or valproate for the short-term treatment of acute manic or mixed episodes associated with bipolar I disorder. Risperidone is also approved in over 30 countries worldwide for bipolar mania either as monotherapy, adjunct therapy, or both monotherapy and adjunct therapy.

Pharmacokinetics of quetiapine in elderly patients with selected psychotic disorders.

Objective: To assess the pharmacokinetics and tolerability of quetiapine in elderly patients with selected psychotic disorders.

Study Design: This was a multicentre, open-label, 27-day, rising multiple-dose trial. Descriptive statistics summarised plasma quetiapine concentrations and pharmacokinetic parameters by trial day.

Duloxetine: a dual reuptake inhibitor.

Objective: To review the pharmacology, pharmacokinetics, clinical efficacy, and safety profile of duloxetine for the treatment of major depressive disorder (MDD).

Data Sources: Searches using MEDLINE and PsycINFO were conducted (1966 to November 2003).

Study Selection And Data Extraction: All duloxetine MDD information gathered was considered.

Long-acting injectable risperidone.

Objective: To review the pharmacology, pharmacokinetics, clinical efficacy, and safety profile of long-acting (LA) risperidone for the treatment of schizophrenia.

Data Sources: Information was selected from PubMed (1965-July 2004). Applicable scientific posters were also used.

Comparative study of the development of diabetes mellitus in patients taking risperidone and olanzapine.

Objectives: A growing body of literature suggests that certain atypical antipsychotics, especially olanzapine and clozapine, may induce glucoregulatory dysfunction. We assessed the differences in risk of developing diabetes mellitus during treatment with olanzapine and risperidone by using patients treated with haloperidol and fluphenazine as control subjects in whom we would not expect to see an increased risk.

Methods: We conducted a retrospective analysis of the Veteran's Integrated Service Network 10 Veterans Affairs (VA) database.

Service use and costs among VA patients with schizophrenia taking risperidone or olanzapine.

Objective: The authors compared the changes in health care utilization and costs between a group of patients with schizophrenia who started treatment with risperidone and a group that started treatment with olanzapine.

Methods: A retrospective analysis was conducted of patients with schizophrenia who were given an initial prescription for risperidone or for olanzapine between March 1997 and March 1999. The change in utilization and cost of inpatient hospitalizations, outpatient clinic visits, medications, and total health care services from one year before to one year after initiation of treatment for the two groups was compared.

Phenylpropanolamine appears not to promote weight loss in patients with schizophrenia who have gained weight during clozapine treatment.

Background: Weight gain is a common side effect of clozapine treatment and may expose patients to obesity-associated health risks. We proposed that concomitant treatment with an appetite suppressant such as phenylpropanolamine (PPA) would lead to a decrease in appetite and therefore loss of weight.

Method: This was a 12-week, double-blind, randomized, placebo-controlled trial of PPA, 75 mg/day, in outpatients with treatment-refractory schizophrenia (DSM-IV) who were stable on clozapine treatment for at least 4 months and had gained > 10% of their baseline body weight since starting clozapine.