The Impact of High-density Lipoprotein Cholesterol (HDL-C) Levels and Risk of Movement Disorders in Patients Taking Antipsychotics.

Introduction: Well-known adverse events of antipsychotics are movement disorders, or extrapyramidal symptoms, such as drug-induced parkinsonism and tardive dyskinesia.

Objective: With new evidence suggesting a link between low high-density lipoprotein cholesterol (HDL-C) and risk of Parkinson's disease, this study sought to investigate if that link also translated to patients taking antipsychotics with low HDL-C and an increased risk for developing a movement disorder.

Design: Adult patients (n=89) at an inpatient state psychiatric facility taking at least one antipsychotic with at least one HDL-C level were assessed for signs of a movement disorder through their history and physical, progress notes, and Abnormal Involuntary Movement Scale (AIMS) score.

Neuroleptic Malignant Syndrome: Can Be an Unrecognized Chronic Fatal Disease.

This case report concentrates on the fatal consequences of the chronic aspects of neuroleptic malignant syndrome (NMS). It is a life-threatening side effect and has been identified since antipsychotics were developed. Efforts to highlight the propensity to develop NMS for those more sensitive to psychotropic medications have been infrequent.

High-dose Clozapine Withdrawal: A Case Report and Timeline of a Single Potential Withdrawal Seizure.

Clozapine, a second-generation antipsychotic (SGA), is known for its superior efficacy in the treatment of refractory schizophrenia. Clozapine's hallmark side effects are well-known, including, but not limited to, drug-induced seizures associated with daily goal doses greater than 600mg and rapid dose escalation, which can also contribute to significant risk of orthostatic hypotension, bradycardia, and syncope. However, less well-known is the potential withdrawal that can occur from its rapid discontinuation.

Exploring the Potential Psychiatric Implications of Astronomical Phenomena.

Our study evaluates the potential psychiatric impact of the full phase of the moon on patients in a state psychiatric hospital in Buffalo, New York, between September 2013 and July 2018. This relationship is presented as the average number of restraints or seclusions (R&S) and code green psychiatric emergencies (CG) recorded 14 days before and 14 days after a full moon. Since the timeframe of the analysis included the August 21, 2017, solar eclipse, we also highlight the correlation between a partial solar eclipse and the number of CG events.

Sialorrhea and aspiration pneumonia: a case study.

This case study compares two different clinical outcomes for a patient with a long-standing psychotic disorder prescribed clozapine on two occasions. During the first trial, clozapine was used at a higher dose for this patient (350-450mg/day) and included clinically significant sialorrhea, pneumonia, and pneumonia-like illnesses requiring immediate medical intervention including hospitalization. There were also patient complaints of fatigue, cough, choking, and constipation leading to poor adherence.

Hematologic impact of antibiotic administration on patients taking clozapine.

Objective: The purpose of this study was to determine if the drop in white blood cell/absolute neutrophil count for clozapine patients on antibiotics is a normal response to the resolution of infection or if the concurrent administration resulted in an abnormal drop in blood counts and further reduction of white blood cell/absolute neutrophil below baseline prior to infection.

Design: This was a retrospective record review of all patients who received clozapine and antibiotics concurrently between June 30, 2010, and June 30, 2011.

Setting: Subjects included inpatients on clozapine therapy at a state psychiatric facility.

Challenging the hypothesized link to season of birth in patients with schizophrenia.

The cause of schizophrenia is unknown; however, one hypothesis is that seasonality of birth contributes to its development, with an excess of winter-spring births observed in those with schizophrenia. There are over 200 studies exploring this issue at the writing of this article with most of the studies revealing a decrease in late summer births and an increase number of winter-spring births of those individuals with the disease.The primary objective of this study was to evaluate the seasonality of birth for 376 institutionalized patients with schizophrenia receiving clozapine treatment in a New York State psychiatric hospital.

Are clozapine patients at risk for blood dyscrasias with concomitant tamiflu use?

Unlabelled: Flu vaccination is the best protection against seasonal flu; however, as mutated strains of the flu develop and/or unvaccinated people are exposed to the wild virus, antiviral prophylaxis becomes more important. High-risk patients, such as those institutionalized, are particularly vulnerable to adverse drug events and possibly even more so during the course of active viral infection. As clinicians pursue antiviral treatment, it is important to know the potential risks of prescribing concurrent medication regimens.

Risperidone long-acting injections: successful alternative deltoid muscle injections for refractory schizophrenia.

Treatment-resistant paranoid schizophrenia is often addressed with long-term intramuscular preparations of conventional antipsychotics (haloperidol and fluphenazine), which can be associated with the development of painful, lumpy nodules at the injection site. In this article, we present a case example of a 58-year-old male patient with paranoid schizophrenia who was treated with risperidone long-acting injection given into the deltoid muscle instead of the US Food and Drug Administration (FDA)-approved gluteal muscle injection site. Use of this agent in the deltoid muscle facilitated healing of the numerous painful lumpy nodules associated with prior trials of conventional long-acting injections.

Continuing day treatment programs promote recovery in schizophrenia: a case-based study.

Continuing day treatment programs focus on community stabilization through comprehensive individualized rehabilitation. They promote recovery through a variety of practical clinical therapeutic interventions. This empirically based report describes a continuing day treatment program's rehabilitation of four clients with schizophrenia, chronic type in a western New York mental health clinic who were in each of the specialty services: a two-phase program, a program for seniors, and a program for co-occurring substance dependence.