Once-monthly injection of paliperidone palmitate in patients with recently diagnosed and chronic schizophrenia: a post-hoc comparison of efficacy and safety.

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Once-monthly injection of paliperidone palmitate in patients with recently diagnosed and chronic schizophrenia: a post-hoc comparison of efficacy and safety.

Expert Opin Pharmacother. 2017 Nov 15;:1-11

Authors: Si T, Zhuo J, Turkoz I, Mathews M, Tan W, Feng Y

Abstract
BACKGROUND: The use of long-acting injectable antipsychotics in recently diagnosed schizophrenia remains less explored. We evaluated the efficacy and safety of paliperidone palmitate once-monthly (PP1M) treatment in adult patients with recently diagnosed vs. chronic schizophrenia.
RESEARCH DESIGN AND METHODS: These post-hoc analyses included two multicenter studies. Study 1 (NCT01527305) enrolled recently diagnosed (≤5 years) and chronic (>5 years) patients; Study 2 (NCT01051531) enrolled recently diagnosed patients only. Recently diagnosed patients were further sub-grouped into ≤2 years or 2-5 years. The primary efficacy endpoint was the change from baseline in Positive and Negative Syndrome Scale (PANSS) total score.
RESULTS: In Study 1, 41.5% patients had recent diagnosis (≤2 years: 56.8%; 2-5 years: 43.2%); 58.5% had chronic schizophrenia. In Study 2, 52.8% and 47.2% patients were grouped into ≤2 years and 2-5 years, respectively. PANSS total score showed significantly greater improvement in patients with recently diagnosed vs. chronic schizophrenia. Similar results were obtained for PANSS responder rate, improvements in PANSS, and CGI-S scores.
CONCLUSION: PP1M was efficacious in both recently diagnosed and chronic schizophrenia, with the benefits being more pronounced in patients with recently diagnosed schizophrenia. This adds to growing evidence recommending long-acting antipsychotic interventions at early stages of schizophrenia.

PMID: 29141463 [PubMed – as supplied by publisher]

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The impact of mental health comorbidities on adherence to buprenorphine: A claims based analysis.

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The impact of mental health comorbidities on adherence to buprenorphine: A claims based analysis.

Am J Addict. 2017 Nov 16;:

Authors: Litz M, Leslie D

Abstract
BACKGROUND AND OBJECTIVES: Previous research has been inconclusive about whether opioid-dependent patients with psychiatric comorbidities have shorter treatment retention and higher relapse rates. This study aims to evaluate the impact of mental health comorbidities on adherence to buprenorphine using a large, national health insurance claims data base.
METHODS: We used MarketScan® data from 2012 to 2014 to perform this analysis. Inclusion criteria included all patients with an opioid use disorder-related ICD-9 code who had been prescribed buprenorphine (n = 2947). Medication adherence was defined using the Medication Possession Ratio ≥.8 (MPR) and logistic regression was used to examine the association between medication adherence and mental health diagnoses, which included Alzheimer’s/dementia, schizophrenia, other psychosis, major depressive disorder/bipolar disorder (MDDBP), anxiety disorder, personality disorder, and mental health disorder not elsewhere specified (NOS).
RESULTS: Of the 2947 patients included in our analysis, the most common diagnoses were anxiety disorder: n = 648 (22.0%), MDDBP: n = 467 (15.9%), and mental health disorder NOS: n = 959 (32.5%). Patients diagnosed with MDDBP were significantly less likely to adhere to opioid pharmacotherapy (OR = .805, 95%CI = .651, .994) than patients without MDDBP.
CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: The presence of a psychiatric comorbidity can significantly affect adherence to buprenorphine. These trends illustrate the need for clinicians treating opioid use disorder with buprenorphine to screen for psychiatric disorders and monitor their medication adherence. There may also be opportunities to design interventions to help this vulnerable population adhere to buprenorphine and other forms of opioid pharmacotherapy. (Am J Addict 2017;XX:1-5).

PMID: 29143483 [PubMed – as supplied by publisher]

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Coping and the stages of psychosis: an investigation into the coping styles in people at risk of psychosis, in people with first-episode and multiple-episode psychoses.

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Coping and the stages of psychosis: an investigation into the coping styles in people at risk of psychosis, in people with first-episode and multiple-episode psychoses.

Early Interv Psychiatry. 2017 Apr;11(2):147-155

Authors: Kommescher M, Gross S, Pützfeld V, Klosterkötter J, Bechdolf A

Abstract
AIM: The concept of coping is central to recent models of psychosis. The aim of the present paper is to explore whether specific coping styles relate to certain stages of the disorder.
METHODS: Thirty-nine clients at clinical high risk (CHR) of first-episode psychosis, 19 clients with first-episode psychosis and 52 clients with multiple-episode psychosis completed a Stress Coping Questionnaire. This questionnaire consists of 114 items defining one overall positive coping scale (with three subscales) and one negative coping scale. Analyses of variance with group as between-subject factor and coping behaviour as within-subject factor were used to identify different coping patterns.
RESULTS: On the level of subscales no group differences could be detected, but analysis of variance revealed slightly different patterns: CHR clients used significantly more negative than positive coping styles (P = 0.001), followed by patients with multiple-episode psychosis (P = 0.074). First-episode patients were most likely to use negative as well as positive coping (P = 0.960). Across all stages of illness, stress control was significantly preferred compared to the other positive coping styles distraction and devaluation. Again, this pattern was especially pronounced for at-risk clients and patients with multiple-episode psychosis, whereas patients with first-episode psychosis were most likely to use devaluation as well as distraction.
CONCLUSIONS: The overall coping styles were similar across the different stages of psychosis. However, at-risk persons presented especially pronounced negative coping and a small range of strategies, indicating a specific need for psychosocial support in this stage of the disorder.

PMID: 25726849 [PubMed – indexed for MEDLINE]

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Discontinuing antipsychotic treatment after a first-episode of psychosis: Who, when and how?

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Discontinuing antipsychotic treatment after a first-episode of psychosis: Who, when and how?
Schizophr Res. 2017 Nov 09;:
Authors: Emsley R
PMID: 29129505 [PubMed – as supplied by publisher]…

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Symptoms of Mental Illness and Their Impact on Managing Type 2 Diabetes in Adults.

Symptoms of Mental Illness and Their Impact on Managing Type 2 Diabetes in Adults.
Can J Diabetes. 2017 Nov 08;:
Authors: Cimo A, Dewa CS
Abstract
OBJECTIVES: People with mental illnesses are more l…

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Reasons for Nonadherence to Psychiatric Medication and Cardiovascular Risk Factors Treatment Among Latino Bipolar Disorder Patients Living in Puerto Rico: A Qualitative Study.

Reasons for Nonadherence to Psychiatric Medication and Cardiovascular Risk Factors Treatment Among Latino Bipolar Disorder Patients Living in Puerto Rico: A Qualitative Study.

Community Ment Health J. 2017 Nov 10;:

Authors: Ralat SI, Depp CA, Bernal G

Abstract
Latinos with bipolar disorder (BD) have a high rate of nonadherence to psychiatric medication and treatment for other medical conditions such as cardiovascular disease (CVD) risk factors than non-Latinos with BD. The aim of this study is to identify patients’ perspectives on the reasons for nonadherence to psychiatric medication and for CVD risk factors conditions in outpatients with BD. Three focus group sessions were held for a total of 22 adults ranging from 23 to 60 years old. Participants had BD, Type I/II and CVD risk factors. Audio-recordings of focus groups were transcribed and a content analysis was performed. Reasons identified as barriers to adherence were somewhat different for BD medications in comparison to CVD risk factors suggesting the need for integrated interventions targeting these barriers to adherence for both BD and CVD risk factors.

PMID: 29127563 [PubMed – as supplied by publisher]

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Face and predictive validity of the ClockΔ19 mouse as an animal model for bipolar disorder: a systematic review.

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Face and predictive validity of the ClockΔ19 mouse as an animal model for bipolar disorder: a systematic review.

Mol Psychiatry. 2017 Nov 07;:

Authors: Kristensen M, Nierenberg AA, Østergaard SD

Abstract
Mice carrying the circadian locomotor output cycles Kaput delta 19 N-ethyl-N-nitrosoure (ENU) mutation (ClockΔ19) are used as an animal model for bipolar disorder (BD). We aimed to systematically review the face validity (phenotypical and pathophysiological resemblance with BD) and predictive validity (responsiveness to treatments used in BD) of this model in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. We carried out a systematic search of the databases PubMed and Embase, combining search terms covering BD and ClockΔ19. The 22 studies included in the review (from a total of 1281 identified records) show that the behavioral phenotype of the ClockΔ19 mouse is characterized by hyperactivity, decreased anxiety-like behavior, decreased depression-like behavior and increased preference for rewarding stimuli. This is highly consistent with mania in humans. Moreover, the ClockΔ19 mouse exhibits rapid mood cycling (a manic-like phenotype during the day followed by euthymia at night), which is consistent with BD. Chronic administration of lithium, a drug with well established mood-stabilizing effect in humans with BD, reverses the majority of the bipolar-like traits and most of the neurobiological abnormalities observed in the ClockΔ19 mouse. In conclusion, the ClockΔ19 mouse has substantial face validity as an animal model for BD. The predictive validity of the ClockΔ19 mouse has primarily been investigated via studies using lithium challenge. Therefore, further studies are needed to determine how the ClockΔ19 mouse responds to other mood-stabilizing treatments of BD such as valproate, lamotrigine, carbamazepine, oxcarbazepine, antipsychotics, electroconvulsive therapy and various light interventions.Molecular Psychiatry advance online publication, 7 November 2017; doi:10.1038/mp.2017.192.

PMID: 29112195 [PubMed – as supplied by publisher]

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Neural Responses to Smoking Cues in Schizophrenia.

Neural Responses to Smoking Cues in Schizophrenia.
Schizophr Bull. 2017 Jul 04;:
Authors: Moran LV, Betts JM, Ongur D, Janes AC
Abstract
The high prevalence of nicotine dependence contributes to exc…

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Beyond Q1/Q2: The impact of manufacturing conditions and test methods on drug release from PLGA-based microparticle depot formulations.

Beyond Q1/Q2: The impact of manufacturing conditions and test methods on drug release from PLGA-based microparticle depot formulations.

J Pharm Sci. 2017 Oct 26;:

Authors: Garner J, Skidmore S, Park H, Park K, Choi S, Wang Y

Abstract
Drug-loaded polymeric microparticles have been used as long-acting injectable (LAI) depot formulations. To obtain FDA approval, a generic LAI depot product needs to be qualitatively (Q1) and quantitatively (Q2) the same in terms of inactive ingredients as its reference listed drug (RLD). However, Q1/Q2 sameness as the RLD does not guarantee the same in vitro drug release profile and in vivo performance, especially when the manufacturing methods are different. There is little consensus on how the in vitro testing needs to be done to examine the release profiles of LAI depot formulations. This study examined the manufacturing differences in making risperidone-loaded poly(lactide-co-glycolide) (PLGA) microparticles and their impact on the release kinetics. It also examined the impacts of in vitro testing methods on the drug release profiles. Two in-house manufactured risperidone PLGA microparticles and Risperdal Consta(®) were used in the study. Of the in vitro release methods tested, the orbital agitation method provided the most reproducible release profiles. The results indicate that the in vitro release kinetics depends not only on manufacturing procedures but also on the in vitro testing conditions, such as the agitation speed, vessel-dimensions, solid beads, media exchange volume, and other parameters both under real-time and accelerated testing conditions. In the current case, the in vitro experimental condition seemed to affect the drug release kinetics more than the manufacturing differences. The developed orbital agitation release testing method is simple, robust, and reproducible, which allows comparison of in vitro release profiles of formulations that are prepared with manufacturing differences.

PMID: 29107048 [PubMed – as supplied by publisher]

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Validation of a four items version of the Functional Remission of General Schizophrenia scale (the mini-FROGS) to capture the functional benefits of clinical remission.

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Validation of a four items version of the Functional Remission of General Schizophrenia scale (the mini-FROGS) to capture the functional benefits of clinical remission.

Eur Psychiatry. 2017 Sep 22;47:35-41

Authors: Mallet J, Lancrenon S, Llorca PM, Lançon C, Baylé FJ, Gorwood P

Abstract
OBJECTIVES: We previously developed the Functional Remission Of General Schizophrenia (FROGS) scale demonstrating first, reliable assessment in a cross-sectional study and second, good time-stability. The purpose of the present analysis was to propose a shorter version (mini-FROGS), more compatible with the limited time available in a psychiatric visit, focusing on the functional domains that have higher likelihood of being improved with higher and/or longer symptomatic remission in different cultural backgrounds.
METHODS: We used multiple regressions to find the most informative items explaining increased length of symptomatic remission, using prospective data from a national observational multicenter survey. Then, the mini-FROGS was used in different European countries to test its between-center reliability, compared to other scales.
RESULTS: Four domains were retained as capturing the maximum of symptomatic remission, namely (1) travel and communication, (2) management of illness and treatment, (3) self-esteem and sense of independence and (4) respect of biological rhythms. First, the mini-FROG was evaluated in 443 French patients with clinical remission and 22 without, and 12/18 months later in 140 patients still in clinical remission and 23 in relapse. In Europe, 295 schizophrenia patients were assessed with the mini-FROGS and other scales devoted to functional remission, allowing comparisons. The mini-FROGS showed good correlations with other scales in different countries and demonstrated good psychometric properties.
CONCLUSION: These results give evidence that a 4 items-only version of the FROGS scale may be useful to assess important aspects of functional remission, tightly linked to the length of clinical remission.

PMID: 29100170 [PubMed – as supplied by publisher]

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