Journal of clinical psychopharmacology
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J Clin Psychopharmacol · Aug 2010
Randomized Controlled TrialA post hoc analysis of negative symptoms and psychosocial function in patients with schizophrenia: a 40-week randomized, double-blind study of ziprasidone versus haloperidol followed by a 3-year double-blind extension trial.
Schizophrenia is a persistent, lifelong illness such that enduring functional improvements may only occur over the course of years [corrected]. This post hoc analysis in stable outpatients with schizophrenia investigated the negative symptom efficacy and treatment outcomes of ziprasidone (80-160 mg/d given twice a day, mean modal dose of 112 mg/d; and 80-120 mg/d given every day, mean modal dose of 96 mg/d) versus haloperidol (5-20 mg/d, mean modal dose of 12 mg/d) in a randomized, 40-week, double-blind study, followed by a double-blind continuation trial that extended up to 156 additional weeks. ⋯ A similar pattern was observed for the ziprasidone 80 to 120 mg group, which showed significant differences versus haloperidol in negative symptom remission and instrumental role functioning (but not other Quality-of-Life subscale measures). The clinically relevant outcome differences detected in this post hoc exploratory analysis support the potential for both enhanced remission in negative symptoms and psychosocial recovery during long-term treatment with an atypical agent and add to our understanding regarding the degree to which negative symptom remission can be attained in the maintenance phase.
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J Clin Psychopharmacol · Aug 2010
Amisulpride overdose is frequently associated with QT prolongation and torsades de pointes.
This study aimed to describe the effects of the antipsychotic amisulpride in overdose, including the frequency of QT prolongation and torsades de pointes. Cases of amisulpride overdose (>1 g) were recruited from 2 state poison centers and a tertiary toxicology unit over 5 years. A 1-page clinical research form was used to collect clinical information. ⋯ Central nervous system effects were uncommon with coma in 7 cases, seizures in 2, and dystonic reactions in 2. Amisulpride overdose commonly causes QT prolongation, bradycardia, and hypotension. Torsades de pointes occurred commonly enough to suggest that amisulpride is highly cardiotoxic in overdose.
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J Clin Psychopharmacol · Jun 2010
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA pooled MADRS/IDS cross-correlation analysis: clinician and patient self-report assessment of improvement in core depressive symptoms with adjunctive aripiprazole.
These analyses aimed to examine the pattern of improvement in depression symptoms with adjunctive aripiprazole. ⋯ This cross-correlation analysis confirmed that improvement in core depressive symptoms with adjunctive aripiprazole was identified by both clinicians and patients. Clinically, these changes were maintained during the study. Theoretically, these findings lead to important questions regarding neurochemical changes produced by aripiprazole when used in combination with antidepressants.
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J Clin Psychopharmacol · Jun 2010
Comparative StudySurvey of investigators' opinions on the acceptability of interactions with patients participating in clinical trials.
There is growing concern about the ability of clinical trials to reliably detect differences between active drugs and placebo. To date, little attention has focused on how interactions between clinical trial investigators and patients may influence study outcomes. We sought to explore what types of interactions with patients investigators considered to be appropriate during placebo-controlled pharmacotherapy studies of major depressive disorder. ⋯ There is significant variability between PIs in what are considered to be appropriate interactions with patients participating in clinical trials. Greater standardization of these interactions is required to reduce placebo response rates and to strengthen the ethical conduct of clinical trials.
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J Clin Psychopharmacol · Feb 2010
ReviewSystematic evaluation of rating scales for drug-induced parkinsonism and recommendations for future research.
Drug-induced parkinsonism (DIP) is one of the most common adverse effects of antipsychotic agents. The limited agreement about which rating scale should be used in clinical practice to assess DIP prompted us to review the feasibility and the psychometric qualities of the available instruments. ⋯ Although various scales are used to assess DIP, few have been evaluated for validity and reliability. The SAS, St Hans Rating Scale for Extrapyramidal Syndromes, and Drug-Induced Extrapyramidal Scale seem to be the most valid, reliable, and easy-to-use instruments to evaluate DIP in clinical practice.