Circadian Rhythm and the Prediction of Relapse in Bipolar Disorder.

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Circadian Rhythm and the Prediction of Relapse in Bipolar Disorder.
J Clin Psychiatry. 2017 Dec 26;79(1):
Authors: Gonzalez R, Tohen M
PMID: 29286594 [PubMed – as supplied by publisher]

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Polyunsaturated fatty acids and recurrent mood disorders: Phenomenology, mechanisms, and clinical application.

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Polyunsaturated fatty acids and recurrent mood disorders: Phenomenology, mechanisms, and clinical application.
Prog Lipid Res. 2017 Apr;66:1-13
Authors: Messamore E, Almeida DM, Jandacek RJ, McNama…

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Comparative Effectiveness of Antipsychotic Drugs for Rehospitalization in Schizophrenia-A Nationwide Study With 20-Year Follow-up.

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Comparative Effectiveness of Antipsychotic Drugs for Rehospitalization in Schizophrenia-A Nationwide Study With 20-Year Follow-up.

Schizophr Bull. 2017 Dec 20;:

Authors: Taipale H, Mehtälä J, Tanskanen A, Tiihonen J

Abstract
Very little is known about the comparative long-term effectiveness of novel antipsychotics in relapse prevention, especially in first-episode schizophrenia. Nationwide data from Finnish health care registers were gathered prospectively for all persons with periods of inpatient care due to schizophrenia in Finland during 1972-2014. Altogether 62250 persons were included in the prevalent cohort, and 8719 in the incident (first-episode schizophrenia) cohort. The follow-up for antipsychotic use started at 1996 for the prevalent cohort, and at the first discharge from inpatient care for the incident cases. Within-individual Cox regression models for risk of psychiatric and all-cause hospitalization were constructed to compare risk during antipsychotic use and no use using individual as his/her own control to eliminate selection bias. With follow-up time up to 20 years (median = 14.1, interquartile range = 6.9-20.0), 59% of the prevalent cohort were readmitted to psychiatric inpatient care. Olanzapine long-acting injection (LAI; adjusted hazard ratio = 0.46, 95% confidence interval = 0.36-0.61), clozapine (0.51, 0.49-0.53), and paliperidone LAI (0.51, 0.40-0.66) were associated with the lowest risk of psychiatric rehospitalization in the prevalent cohort. Among first-episode patients, the lowest risks were observed for flupentixol LAI (0.24, 0.12-0.49), olanzapine LAI (0.26, 0.16-0.44), and perphenazine LAI (0.39, 0.31-0.50). Clozapine and LAIs were associated with the lowest risk of all-cause hospitalization in both cohorts. Clozapine and LAIs are the most effective treatments in preventing psychiatric and all-cause hospitalization among chronic and first-episode patients with schizophrenia.

PMID: 29272458 [PubMed – as supplied by publisher]

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A Patient-Centered Antipsychotic Medication Adherence Intervention: Results From a Randomized Controlled Trial.

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A Patient-Centered Antipsychotic Medication Adherence Intervention: Results From a Randomized Controlled Trial.
J Nerv Ment Dis. 2017 Dec 14;:
Authors: Pyne JM, Fischer EP, Mittal D, Owen R

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Ethnic and Age Disparities in Patients Taking Long-acting Injectable Atypical Antipsychotics.

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Ethnic and Age Disparities in Patients Taking Long-acting Injectable Atypical Antipsychotics.

Cureus. 2017 Oct 12;9(10):e1772

Authors: Soleman M, Lam N, Woo BK

Abstract
Introduction This study will determine whether different ethnicities and different age groups receive equal amounts of long-acting atypical antipsychotics in comparison to their oral equivalents. Methods Secondary analyses of data from the Los Angeles County Department of Health Services Electronic Health Record (total N=63,134 inpatient visits) were performed. Chi-squared statistics were used to compare ethnicity and age with the use of either risperidone injectable or paliperidone palmitate (r-LAIs) versus risperidone oral. Results Among the 63,134 total inpatient visits, there were 3,011 patient visits that included the use of an atypical antipsychotic. Of these 3,011 visits, 452 (15.0%) were on r-LAIs and 2,559 (85.0%) were on risperidone oral. No statistically significant disparities were identified with the use of r-LAIs as compared to oral risperidone amongst ethnic groups (chi-square = 0.88, df = 3, p = 0.831). However, there was a statistically significant difference with the use of r-LAIs as compared to oral Risperidone amongst age groups, favoring younger patients (chi-square = 13.46, df = 3, p < 0.004). Conclusion Our data indicate a lack of ethnic disparities in prescribing long-acting atypical antipsychotics and an increased percentage of younger patients being treated with atypical depot antipsychotics over their oral equivalents.

PMID: 29238631 [PubMed]

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Risk of recurrence after a single manic or mixed episode – a systematic review and meta-analysis.

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Risk of recurrence after a single manic or mixed episode – a systematic review and meta-analysis.

Bipolar Disord. 2017 Dec 14;:

Authors: Kessing LV, Andersen PK, Vinberg M

Abstract
OBJECTIVES: For the first time to estimate the risk of recurrence among patients with a single manic/mixed episode by systematically reviewing prior studies on cohorts of adults, and cohorts of children and adolescents, respectively.
METHODS: A systematic literature search up to August 2017 was carried out including studies in which < 25% of the participants were estimated to have had a mood episode that required pharmacological treatment prior to the index manic or mixed episode at inclusion.
RESULTS: Three studies including a total of 293 adult patients with a single manic or mixed episode and three studies of children and adolescents including 126 patients were identified. In the adult studies, 31%, 40% and 42% experienced recurrence after recovery within 1 year, 59% after 2 years, and 58% after 4 years, respectively. In the studies on children and adolescents, 40% and 52% experienced recurrence after recovery within 1 year, 30% and 60% after 2 years and 64% and 67% after 4 to 5 years, respectively. Results from meta-analyses showed a 1-year rate of recurrence of 35% (95% confidence interval [CI]: 30-41%) in adults, and in adolescents/children, a 1-year rate of recurrence of 48% (95% CI: 38-58%), a 2-year rate of 46% (95% CI: 33-60%) and a 4-5-year rate of recurrence of 65% (95% CI: 52-77%; as data from different studies were included at 1, 2 and 5 years, rates of recurrence did not increase steadily with time).
CONCLUSIONS: The rate of recurrence is high among adults as well as children and adolescents. It is important that clinicians and patients as well as relatives are well informed about these high risks when deciding to start maintenance treatment or not following onset of a single manic or mixed episode.

PMID: 29239075 [PubMed – as supplied by publisher]

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Personalized management of bipolar disorder.

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Personalized management of bipolar disorder.
Neurosci Lett. 2017 Dec 02;:
Authors: Alda M, Manchia M
Abstract
Bipolar disorder (BD) is one of the most serious psychiatric disorders….

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Quality of Diabetes Care for Individuals with Comorbid Chronic Psychotic Illness: A Sex-Based Analysis.

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Quality of Diabetes Care for Individuals with Comorbid Chronic Psychotic Illness: A Sex-Based Analysis.

J Womens Health (Larchmt). 2017 Dec 06;:

Authors: Barker LC, Kurdyak P, Jacob B, Vigod SN

Abstract
BACKGROUND: Diabetes is common among individuals with chronic psychotic illness, yet they receive lower quality of diabetes care than those without psychosis. Men usually receive higher quality diabetes care than women, but whether this holds true in chronic psychotic illness populations is unknown. We aimed to determine whether quality of diabetes care differs between men and women with chronic psychotic illness.
METHODS: This population-based cohort study used Ontario health administrative data to compare women and men with comorbid chronic psychotic illness and diabetes mellitus (2011-2013). The primary outcome was adherence to diabetes monitoring guidelines, defined as ≥1 retinal exam, ≥4 hemoglobin A1c (HbA1c) tests, and ≥1 dyslipidemia test during a 2-year period. Logistic regression models compared women to men to generate adjusted odds ratios (aOR) and confidence intervals (95% CI), adjusting for potential confounding variables.
RESULTS: Women with chronic psychotic illness (n = 13,972) were slightly more likely to receive guideline-adherent diabetes monitoring than men (n = 12,287) (25.2% vs. 23.0%; aOR 1.20, 95% CI 1.10-1.30), including a greater likelihood of receiving ≥1 retinal exam (aOR 1.13, 95% CI 1.08-1.19) and ≥4 HbA1c tests (aOR 1.06, 95% CI 1.01-1.12). There was no difference in receipt of ≥1 dyslipidemia test (aOR 1.04, 95% CI 0.99-1.11).
CONCLUSIONS: Quality of diabetes monitoring is similarly poor in women and men with chronic psychotic illness, with women receiving only marginally more optimal monitoring than men. This differs from patterns in the general population, and could have implications when designing and implementing interventions to improve diabetes care in women and men with chronic psychotic illness.

PMID: 29211592 [PubMed – as supplied by publisher]

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Re: Review article titled ‘Clinical benefits and impact of early use of long-acting injectable antipsychotics for schizophrenia’ (Stevens GL et al. Early Interv Psychiatry 2015 Sep 25. doi: 10.1111/eip.12278).

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Re: Review article titled ‘Clinical benefits and impact of early use of long-acting injectable antipsychotics for schizophrenia’ (Stevens GL et al. Early Interv Psychiatry 2015 Sep 25. doi: 10.1111/eip.12278).

Early Interv Psychiatry. 2016 10;10(5):378-9

Authors: Alphs L, Bossie C, Sliwa JK

PMID: 26812939 [PubMed – indexed for MEDLINE]

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Efficacy and safety of aripiprazole lauroxil once-monthly versus aripiprazole once-monthly long-acting injectable formulations in patients with acute symptoms of schizophrenia: an indirect comparison of two double-blind placebo-controlled studies.

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Efficacy and safety of aripiprazole lauroxil once-monthly versus aripiprazole once-monthly long-acting injectable formulations in patients with acute symptoms of schizophrenia: an indirect comparison of two double-blind placebo-controlled studies.

Curr Med Res Opin. 2017 Nov 27;:1-20

Authors: Cameron C, Zummo J, Desai D, Drake C, Hutton B, Kotb A, Weiden PJ

Abstract
BACKGROUND: Aripiprazole lauroxil (AL) is a long-acting injectable atypical antipsychotic recently approved for the treatment of schizophrenia.
OBJECTIVE: To indirectly compare the safety and efficacy of AL and aripiprazole once-monthly (AOM).
METHODS: We performed a systematic search to identify randomized, controlled trials of AOM and AL that met criteria for indirect comparison according to Bayesian network meta-analysis. The analysis indirectly compared AL and AOM treatment groups for efficacy by mean change in Positive and Negative Syndrome Scale (PANSS) total score and ≥30% reduction in PANSS total score, as well as tolerability including adverse events, akathisia, and weight gain.
RESULTS: Two studies were selected, resulting in three active-treatment groups: AL 441 mg, AL 882 mg, and AOM 400 mg. All active treatments were efficacious compared with placebo. There were no differences in indirect comparisons of akathisia. All three groups showed some weight gain, but only the AOM 400 mg group was significantly greater than placebo.
CONCLUSIONS: Results of this indirect comparison found that both doses of AL and the single AOM dose were therapeutic and efficacious for the treatment of schizophrenia with a similar safety profile.

PMID: 29179595 [PubMed – as supplied by publisher]

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