schizophrenia treatment

精神分裂症治疗
  • 文章类型: Journal Article
    在39%的精神分裂症患者中,精神病症状的发作发生在19岁之前。青少年精神分裂症的批准治疗选择有限。Brexpiprazole于2022年获得美国食品和药物管理局(FDA)批准用于治疗青少年精神分裂症。
    将成人数据外推至青少年,并使用药物模型结合公开的长期安全性数据,FDA批准了宝立哌唑治疗青少年精神分裂症。这些都在这里进行了综述。
    D2受体部分激动剂抗精神病药物在精神病治疗的早期阶段是优选的。在青少年精神分裂症中批准brexpiprazole提供了另一种选择。Brexpiprazole是FDA根据成人数据外推批准的,没有在青少年中进行对照试验。这减少了年轻人的安慰剂暴露。先前批准用于成人精神分裂症的两种药物(阿塞那平和齐拉西酮)在青少年精神分裂症研究中未能与安慰剂分开;这在一定程度上破坏了外推过程。对于布立哌唑,青少年数据的匮乏使其沦为二线代理。需要更多的研究来描述其在青少年精神分裂症管理中的相对作用。
    UNASSIGNED: The onset of psychotic symptoms occurs prior to age 19 in 39% of the patients with schizophrenia. There are limited approved treatment options for adolescents with schizophrenia. Brexpiprazole was approved by the United States Food and Drug Administration (FDA) for treatment of schizophrenia in adolescents in 2022.
    UNASSIGNED: Extrapolation of adult data to youth and use of pharmacologic modeling coupled with open long-term safety data were used by the FDA to approve brexpiprazole for adolescent schizophrenia. They were all reviewed herein.
    UNASSIGNED: D2 receptor partial agonist antipsychotic agents are preferred in the early phase of treatment of psychotic disorders. Approval of brexpiprazole in adolescent schizophrenia provides an additional option. Brexpiprazole was approved by the FDA on the basis of extrapolation of adult data without controlled trials in adolescents. This reduces placebo exposure in young people. Two previous agents (asenapine and ziprasidone) approved for adult schizophrenia failed to separate from placebo in adolescent schizophrenia studies; this partially undermines the process of extrapolation. For brexpiprazole, the paucity of data in adolescents relegates it to a second-line agent. More research on brexpiprazole is needed to delineate its relative role in the management of adolescent schizophrenia.
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  • 文章类型: Journal Article
    UNASSIGNED: This is a comprehensive review of the literature regarding the use of Lumateperone tosylate for schizophrenia. This review presents the background, evidence, and indications for the use of lumateperone tosylate in the treatment of schizophrenia.
    UNASSIGNED: Schizophrenia is a chronic mental health disorder that affects approximately 3.3 million people in the United States. Its symptoms, which must be present more than six months, are comprised of disorganized behavior and speech, a diminished capacity to comprehend reality, hearing voices unheard by others, seeing things unseen by others, delusions, decreased social commitment, and decreased motivation. The majority of these symptoms can be managed with antipsychotic medication. Lumateperone is a selective and concurrent modulator of serotonin, dopamine, and glutamate, which all mediate or modulate serious mental illness.
    UNASSIGNED: Schizophrenia is a complex, severe mental illness that affects how the brain processes information. There are many medications used to treat schizophrenia. One antipsychotic agent, lumateperone tosylate, is a newer agent that the FDA recently approved. The most common adverse effects are shown to be mild such as somnolence, constipation, sedation, and fatigue, with the 42 mg recommended dose. Lumateperone tosylate is an FDA-approved drug that can be given only at the 42mg dose once daily with no titration requirements.
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  • 文章类型: Journal Article
    目的:这是对阿立哌唑月桂酯用于精神分裂症的文献的综合综述。这篇综述介绍了背景,证据,以及在当前精神分裂症发展理论的背景下使用阿立哌唑月桂酯治疗精神分裂症的适应症。
    结果:精神分裂症是一种慢性精神疾病,目前在美国影响约330万人。其症状,必须存在六个月以上,由杂乱无章的行为和言论组成,理解现实的能力减弱,听到别人听不到的声音,看到别人看不见的东西,妄想,社会承诺减少,动力下降。这些症状中的大多数可以用抗精神病药物治疗。阿立哌唑月桂酯是一种长效肌内注射剂,可作为D2和5-HT1A受体的部分激动剂活性与5-HT2A受体的拮抗剂活性的组合。它可以作为4-,6-,或8周注射,取决于口服剂量。阿立哌唑月桂酯于2015年10月获得FDA批准。
    结论:如果不及时治疗,精神分裂症是一种严重的精神疾病。有多种药物可以帮助治疗精神分裂症。一种抗精神病药,月桂酸阿立哌唑,提供长时间注射,优化和提高合规性。已知的副作用包括体重增加,静坐不能,抗精神病药恶性综合征,迟发性运动障碍,和直立性低血压。阿立哌唑月桂酯是FDA批准的药物,可以每月给药,每六周,或每两个月一次,并被证明是安全有效的。
    OBJECTIVE: This is a comprehensive review of the literature regarding the use of Aripiprazole lauroxil for schizophrenia. This review presents the background, evidence, and indications for using aripiprazole lauroxil to treat schizophrenia in the context of current theories on the development of schizophrenia.
    RESULTS: Schizophrenia is a chronic mental health disorder that currently affects approximately 3.3 million people in the United States. Its symptoms, which must be present for more than six months, are comprised of disorganized behavior and speech, a diminished capacity to comprehend reality, hearing voices unheard by others, seeing things unseen by others, delusions, decreased social commitment, and decreased motivation. The majority of these symptoms can be managed with antipsychotic medication. Aripiprazole lauroxil is a long-acting intramuscular injection that works as a combination of partial agonist activity at D2 and 5-HT1A receptors combined with antagonist activity at 5-HT2A receptors. It can be dosed as a 4-, 6-, or 8-week injection, depending on oral dosage. Aripiprazole lauroxil was FDA approved in October of 2015.
    CONCLUSIONS: Schizophrenia is a severe psychiatric disorder if left untreated. There are multiple medications to help treat schizophrenia. One antipsychotic agent, aripiprazole lauroxil, offers long duration injections that optimize and improve compliance. Known side effects include weight gain, akathisia, neuroleptic malignant syndrome, tardive dyskinesia, and orthostatic hypotension. Aripiprazole lauroxil is an FDA-approved drug that can be administered monthly, every six weeks, or every two months and has been shown to be both safe and effective.
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  • 文章类型: Journal Article
    精神分裂症是全球疾病负担的前25个原因之一,就与疾病一起生活的年份以及它对社会造成的情感和经济压力而言。已经使用了几种策略来治疗患者,特别使用典型和非典型精神活性物质。然而,由于其多因素特征和患者抵抗力,精神分裂症仍然是一种难以诊断和治疗的疾病。因此,必须研究新的诊断和治疗策略,以优化疗效并减少实际治疗的副作用。纳米医学试图通过使用纳米级载体来改善用于治疗疾病的低分子量分子试剂。在纳米医学中,纳米心理学专门研究纳米技术在解决精神病学问题中的潜在作用。因此,这项工作的目的是概述纳米精神病治疗精神分裂症的最新技术。
    Schizophrenia is one of the top 25 causes of global diseases burdens in terms of years lived with the disease and the emotional and economical strains it imposes on the society. Several strategies have been used to treat the patients, specially using typical and atypical psychoactives. However, due to its multifactorial characteristic and patient resistance, schizophrenia is still a difficult disease to diagnose and treat. Thus, new strategies for diagnostics and treatment must be researched to optimize the efficacy and reduce the side effects of the actual therapy. Nanomedicine tries to improve low-weight molecular agents for treatment of diseases through the use of nanoscaled carriers. Among nanomedicine, nanopsychiatry specifically deals with the potential role of nanotechnology in solving psychiatry diseases problems. Therefore, the objective of this work is to provide an overview of the state of the art of nanopsychiatry in the sense of treating schizophrenia.
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  • 文章类型: Journal Article
    奥氮平(OLZ),用于治疗双相情感障碍和精神分裂症,在病理生理学中呈现氧化应激的疾病。它具有低水溶性,这可能导致口服生物利用度低。寻找新的药物递送系统(DDS),可能增加OLZ的溶解速率,与研究负载系统的抗氧化潜能相关的研究对于了解双相情感障碍和精神分裂症治疗的改善具有重要意义。因此,本研究旨在评估负载有5%OLZ(CaAl和NiAl)的两种不同的层状双氢氧化物(LDH)的体外抗氧化潜力,通过自由基清除活性(2,2-二苯基-1-吡啶酰肼和一氧化氮);自由基阳离子清除活性(2,2'-偶氮-双3-乙基苯并噻唑啉-6-磺酸ABTS)和评估硫代巴比妥酸(TBARS)对脂质过氧化的抑制能力。结果表明,在所有方法中,当与OLZ相关时,两种获得的LDH系统均呈现体外抗氧化能力,与纯药物相比,含有OLZ的系统的这种活性更为明显。具有CaAl的系统显示出增加的抗氧化潜力,与NiAl相比,将抗氧化活性提高到40,83%,15,84%和16,73%,正如DPPH所显示的,一氧化氮和TBARS测试,分别。结果表明,使用LDH作为功能性赋形剂可能在制药行业中用于双相情感障碍和精神分裂症治疗。
    Olanzapine (OLZ), is used in the treatment of bipolar disorder and schizophrenia, diseases that present oxidative stress in their physiopathology. It has low aqueous solubility, which may lead to low oral bioavailability. The search of new drug delivery systems (DDSs) that may increase dissolution rate of OLZ, associated with the investigation of the antioxidant potential of the loaded-systems become of major importance to understand improvement in bipolar disorder and schizophrenia therapy. Thus, this study aimed to evaluate the in vitro antioxidant potential of two different Layered Double Hydroxides (LDH) loaded with 5% of OLZ (CaAl and NiAl), by radical scavenging activity (2,2-Diphenyl-1-picrylhydrazyl and nitric oxid); radical cation scavenging activity (2,2\'-azino-bis3-ethylbenzthiazoline-6-sulfonic acid ABTS) and evaluation of inhibition capacity of lipid peroxidation by thiobarbituric acid (TBARS). The results showed that both obtained LDH systems presented in vitro antioxidant capacity when associated with OLZ in all methods performed, and this activity is more pronounced with the systems containing OLZ compared to pure drug. The systems with CaAl was shown to have increased antioxidant potential, compared to NiAl, increasing the antioxidant activity up to 40,83%, 15,84% and 16,73%, as showed by the DPPH, nitric oxide and TBARS tests, respectively. The results revealed that the use of LDHs as a functional excipient may be promising in the pharmaceutical industry for bipolar disorder and schizophrenia therapy.
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  • 文章类型: Journal Article
    Nesfatin-1和ghrelin是两种具有相反作用并在食物摄入中起作用的激素。这项研究是基于代谢综合征和精神疾病与nesfatin-1和ghrelin相关的想法计划的。在这项研究中,目的是调查精神分裂症患者ghrelin和nesfatin-1的水平,以混杂因子作为代谢综合征(MS)。55名精神分裂症患者和33名健康对照者被纳入研究。55名患者中有11名(%20)患有MS。已将患有MS的精神分裂症患者的血清ghrelin和nesfatin-1水平与健康对照和无MS的精神分裂症患者进行了比较。精神分裂症患者的血清nesfatin-1水平明显高于健康对照组。但是两组的血清ghrelin水平没有差异。MS精神分裂症患者的血清nesfatin-1浓度(10.51-350.8pg/ml)明显高于健康对照组(4.86-68.91pg/ml)。三组之间的ghrelin水平无统计学差异。我们的研究结果表明,MS的存在也有助于显著高水平的nesfatin-1水平。Nesfatin-1可能参与有关精神分裂症治疗及其代谢作用的新研究。
    Nesfatin-1 and ghrelin are two hormones which has opposite effects and play role in food intake. This study was planned on the idea that both metabolic syndrome and psychiatric disorders are associated with nesfatin-1 and ghrelin. In this study, it was aimed to investigate the levels of ghrelin and nesfatin-1 in patients with schizophrenia, by taking confounding factor as the metabolic syndrome (MS). 55 patients with schizophrenia and 33 healthy controls were included in the study.11 out of the 55 patients (%20) has MS. Serum ghrelin and nesfatin-1 levels of schizophrenia patients with MS have been compared with both healthy controls and schizophrenia patients without MS. Patients with schizophrenia had significantly higher serum nesfatin-1 levels compared to healthy controls. But serum ghrelin levels was not different in both groups. Serum nesfatin-1 concentrations were significantly higher in the schizophrenia patients with MS (10.51-350.8pg/ml) with respect to the healthy control group (4.86-68.91pg/ml). There was no significant statistical difference between the three groups in terms of ghrelin levels. Our findings suggests that, MS presence also contributed to significantly high levels of nesfatin-1 level. Nesfatin-1 may have a part in a novel studies regarding the treatment of schizophrenia and its metabolic effects.
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  • 文章类型: Journal Article
    治疗研究采用确定哪些患者有资格参与和哪些没有资格参与的标准。当这样的排除标准产生的治疗研究样本是所有患有特定疾病的患者的一小部分且不具有代表性的子集时,临床医生可能会犹豫将研究结果应用于一线临床实践。因此,本文回顾了有关精神分裂症治疗研究中排除标准的英文文献,并就其影响得出初步结论.经验得出的排除率估计差异很大(31.0-98.2%),但现有的最佳证据表明,5例精神分裂症患者中约有4例不符合参加典型治疗研究的资格。女性特别有可能被排除在精神分裂症治疗研究之外,从临床和社会正义的角度来看,这都是有问题的。被排除的患者也往往比符合条件的患者年龄大,and,尽管只有少数研究对其进行了研究,与被允许参与研究的患者相比,他们在基线时往往会出现更严重的问题,并且随着时间的推移结局也会不同.在精神分裂症治疗研究中更有限地使用排除标准将有利于增加普遍性,但也可能涉及成本,特别是需要更大的样品。改善治疗结果研究报告的更适度的步骤包括要求充分描述以下理由:和性质,任何排除标准,and,在讨论部分有一个指定的地方,提请注意概括的适当范围。
    Treatment research studies employ criteria that determine which patients are eligible to participate and which are not. When such exclusion criteria produce a treatment research sample that is a small and unrepresentative subset of all patients with a particular disease, clinicians may be hesitant to apply the research results in front-line clinical practice. Accordingly, the present paper reviews the English-language literature on exclusion criteria in schizophrenia treatment research and draws initial conclusions about their impact. Empirically derived estimates of the rate of exclusion vary widely (31.0-98.2%), but the best available evidence suggests that about 4 in 5 patients with schizophrenia would be ineligible to enroll in a typical treatment research study. Women are particularly likely to be excluded from schizophrenia treatment research, which is problematic from both a clinical and social justice viewpoint. Excluded patients also tend to be older than eligible patients, and, though it has been examined in only a few studies, they also tend to have more severe problems at baseline and different outcomes over time than patients who are allowed to participate in research. More limited use of exclusion criteria in schizophrenia treatment research would be beneficial in terms of increasing generalizability, but would also potentially involve costs, particularly a need for larger samples. More modest steps that would improve treatment outcome research reports include requiring a full description of the rationale for, and nature of, any exclusion criteria, and, having a designated place in the discussion section which draws attention to the proper scope of generalization.
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  • 文章类型: Journal Article
    精神分裂症急性期治疗所需的抗精神病药物剂量已确定,但对于维持阶段所需的剂量尚无共识。目前的指南没有对精神分裂症维持治疗所需的抗精神病药物剂量提供明确的建议,可能是由于有限的研究。在这项回顾性研究中,研究了在现实生活中精神分裂症维持治疗中规定的最小抗精神病药剂量。包括在维持期治疗期间临床总体印象-严重程度(CGI-S)≤3至少六个月的精神分裂症患者(n=163)。回顾了这些患者的医疗记录,并记录了用于急性期和维持期治疗的抗精神病药剂量。维持治疗期间使用的平均抗精神病药剂量比急性期使用的剂量低约30%。重要的是,约40%的受试者在低于推荐治疗范围的剂量下保持良好。在维持阶段治疗期间,发病年龄较早和疾病持续时间较长与更高的抗精神病药物剂量要求相关。如果在系统的前瞻性研究中重复,这些发现可能具有重要的临床意义。
    The dose of antipsychotic required for acute phase treatment of schizophrenia is well established, but there is no consensus on dose required for maintenance phase. Current guidelines do not provide definitive recommendations on the dose of antipsychotics needed in the maintenance treatment of schizophrenia, possibly due to limited research. In this retrospective study, minimum antipsychotic dose prescribed in maintenance treatment of schizophrenia in a real life situation was examined. Schizophrenia patients having Clinical Global Impression - Severity (CGI-S)≤3 for at-least six months during the maintenance phase treatment were included (n=163). The medical records of these patients were reviewed and the antipsychotic dose prescribed for acute and maintenance phase treatment was recorded. The mean antipsychotic dose used during maintenance treatment was approximately 30% lower than the dose used during acute phase. Importantly, about 40% of the subjects maintained well with a dose lesser than the recommended therapeutic range. Earlier age at onset and longer duration of illness were associated with higher antipsychotic dose requirement during the maintenance phase treatment. These findings could have important clinical implications if replicated in systematic prospective studies.
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