Development of Psychotropic Medication Utilization Parameters for Foster Children.
In both the professional and lay press, increased attention has been devoted to the use of psychotropic medication in children. In particular, foster children are a vulnerable population that are often fraught with mental or psychiatric disorders, and scrutiny has occurred regarding the use of psychotropic medication in these individuals. Methodologies improving the use of psychotropic medications in this population are needed.
A comprehensive review of ziprasidone and the QTc Interval
This comprehensive review for ziprasidone, a drug with modest QTc prolongation, using clinical data from Pfizer-sponsored randomized clinical trials (RCTs), post-marketing safety surveillance and the Ziprasidone Observational Study of Cardiac Outcomes (ZODIAC) trial aims to provide practitioners an essential reference on this safety issue.
A Cross Country Study of The Effect of Three Dibenzodiazepines: Clozapine, Quetiapine And Olanzepine On Thyroid Function In Patients With Schizophrenia
Thyroid function is very important in psychiatric disorders. Thyroid plays very important role in disease states such as schizophrenia and mood disorders. Atypical antipsychotics including dibenzodiazepines class often used as the first line agent to treat schizophrenia or schizoaffective disorders. Based on several case reports, clozapine, quetiapine and olanzepine are found to decrease thyroid hormone, TT4, FT4 and FT3. This can complicate psychiatric treatment regimen and delay the disease recovery process.
A POOLED ANALYSIS OF THE EFFECTS OF ASENAPINE ON THE PERSISTENT NEGATIVE SYMPTOMS OF SCHIZOPHRENIA
Asenapine and olanzapine reduced persistent negative symptoms (PNS) of schizophrenia in a study population that also met criteria for predominant negative symptoms in 2 double-blind, randomized 26-week core and subsequent 26-week extension studies; superiority of asenapine over olanzapine was observed in neither core study and in only 1 extension. To further explore these effects, we conducted pooled post hoc analyses of these trials.
A Review of Behavioral Health Inpatients Discharged on Two or More Antipsychotic Medications
Previous studies of antipsychotic prescribing have found 30-40% of patients in psychiatric hospitals are prescribed more than one antipsychotic. Despite the lack of clinical evidence supporting the use of two or more antipsychotics in combination there is concern the practice is increasing.
Additionally, researchers have documented when patients receive multiple antipsychotic medications they experience more severe side effects and have poorer outcomes than those prescribed a single antipsychotic medication.
The Joint Commission implemented the Hospital Based Inpatient Psychiatric Services (HBIPS) core measure set on January 1, 2011. These new standards will be used by The Joint Commission and stand alone psychiatric hospitals to evaluate how many patients are discharged on two or more antipsychotics and if prescribers provide appropriate justification for the use of two or more antipsychotics in the patient's medical record. The HBIPS core measure set identifies three primary criteria for appropriate justification including documentation of three or more previous failed trials of single antipsychotics, a plan to cross taper two antipsychotics, and the addition of clozapine to the medication regimen.
Abnormal Triiodothyronine Levels in a 12 Year Old on Lithium
Lithium is indicated for the treatment of an acute mania episode of bipolar disorder or bipolar maintenance in children 12 years old and older. Lithium commonly causes hypothyroidism, but very rarely hyperthyroidism.
ADHERENCE AND CLINICAL OUTCOME OF METABOLIC MONITORING IN PSYCHIATRIC PATIENTS TRANSITIONING FROM AN INPATIENT TO OUTPATIENT SETTING
In 2003, the Food and Drug Administration added warnings to second generation antipsychotic (SGA) drug labels discussing increased risk of hyperglycemia and diabetes. The warnings were initiated to educate providers of the risk and need for monitoring. A consensus statement was published by the American Diabetes Association (ADA), American Psychiatric Association (APA), American Association of Clinical Endocrinologists (AACE), and North American Association for the Study of Obesity (NAASO) describing the metabolic risks associated with SGAs and specifying a monitoring protocol. It has been reported that greater than 50% of patients taking antipsychotics are not monitored for diabetes and dyslipidemia.
Adherence to Selective Serotonin Reuptake Inhibitors in OEF/OIF Veterans with Mental Health Disorders: The Impact of Pharmacist Services
The purpose of this study is to evaluate the benefit of clinical pharmacy intervention on selective serotonin reuptake inhibitor (SSRI) adherence rates in OEF/OIF veterans with a diagnosis of posttraumatic stress disorder (PTSD), other anxiety disorders, depression, or adjustment disorder. The primary objective is to compare SSRI adherence rates in OEF/OIF veterans who receive clinical pharmacist intervention to OEF/OIF veterans who do not.
AGRANULOCYTOSIS ASSOCIATED WITH PSYCHOTROPIC MEDICATIONS: A FATAL CASE
Drug-induced agranulocytosis is a rare, but potentially fatal adverse event that has been reported with most classes of psychotropic medications. Although the incidence is low, drug-induced agranulocytosis and neutropenia are serious and potentially life-threatening complications.The incidence of drug-induced agranulocytosis is not well known for most psychotropic medications.
ALL CAUSE MORTALITY IN OLDER VETERANS WITH DEMENTIA ON LONG-TERM ATYPICAL ANTIPSYCHOTICS
In April 2005, the Food and Drug Administration (FDA) declared that atypical antipsychotics hold a 1.6-1.7 times greater risk of mortality compared with placebo in elderly patients with dementia. Despite such a warning, the atypical antipsychotics continue to be used widely in the treatment of dementia related psychosis in elderly patients due to a lack of other effective and safe treatment options. Follow up studies also found increased risk with atypical antipsychotics. However, none of the trials reviewed were designed to assess risk of mortality and most of the trials reviewed were less than 12 weeks and had few subjects.