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Related Concept Videos

Psychosis: Goals of Pharmacotherapy01:26

Psychosis: Goals of Pharmacotherapy

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Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
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Drug Therapy01:28

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The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
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Psychosis and Antipsychotic Drugs: Overview01:28

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The term "psychosis" refers to a spectrum of mental disorders characterized by abnormal thoughts, perceptions, and behaviors. It can manifest as mood disorders, dementia, delirium with psychotic features, substance-induced psychosis with psychotic features, brief psychotic disorder, delusional disorder, schizoaffective disorder, and schizophrenia. Among all these disorders, schizophrenia is the most common psychotic disorder, affecting 1% of the worldwide population. Psychotic...
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Antipsychotic Drugs: Therapeutic Uses and Side Effects01:21

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Antipsychotic drugs primarily block dopamine and serotonin receptors and cholinergic, adrenergic, and histaminergic receptors, thereby reducing hallucinations and delusions in conditions like schizophrenia. However, they can trigger unwanted extrapyramidal effects such as dystonias, Parkinson-like symptoms, and tardive dyskinesia.
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Antipsychotic drugs are classified into first-generation (typical) drugs including phenothiazines; and second-generation (atypical) drugs. Chlorpromazine hydrochloride (Thorazine), a phenothiazine derivative, broadly impacts the central, autonomic, and endocrine systems. This drug, along with typical agents like haloperidol (Haldol), primarily works by antagonizing D2 receptors, thus reducing dopaminergic neurotransmission. However, typical antipsychotics can cause side effects such as sedation...
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Schizophrenia, a complex psychiatric disorder, has been historically misunderstood. Early psychological theories attributed its origins to childhood trauma and unresponsive parenting. However, contemporary research largely rejects these notions, favoring the vulnerability-stress hypothesis. This model proposes that individuals with a genetic predisposition to schizophrenia may develop the disorder following exposure to significant environmental stressors. Notably, studies on high-risk...
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Clozapine use - has practice changed?

Roberta Rowntree1, Sean Murray2, Felicity Fanning1

  • 1DETECT, Blackrock, Ireland.

Journal of Psychopharmacology (Oxford, England)
|April 17, 2020
PubMed
Summary
This summary is machine-generated.

Clozapine is increasingly used for treatment-resistant schizophrenia, showing reduced hospitalizations. However, delays in initiation and treatment discontinuation remain challenges in managing schizophrenia.

Keywords:
clozapinedopamine serotonin and adrenaline receptor antagonistfirst-episode psychosispsychosistreatment-resistant schizophrenia

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Pharmacology

Background:

  • Approximately one-third of schizophrenia patients have treatment-resistant illness.
  • Up to 60% of these patients may respond to clozapine treatment.

Purpose of the Study:

  • To examine clozapine prescribing patterns against National Institute for Health and Care Excellence (NICE) guidelines.
  • To assess the impact of clozapine on hospitalisation rates in first-episode psychosis.

Main Methods:

  • Retrospective analysis of 339 first-episode psychosis patients.
  • Comparison of clozapine prescribing against NICE guidelines.
  • Assessment of hospitalisation data before and after clozapine initiation.

Main Results:

  • 32 patients (9.4%) received clozapine, with a mean delay of 2.1 years.
  • Average antipsychotic trials before clozapine were 2.74.
  • Clozapine significantly reduced hospital admissions (2.3 to 0.3 per year) and days hospitalized (147 to 53).
  • 18 patients discontinued clozapine during follow-up.

Conclusions:

  • Clozapine is being prescribed earlier, but delays persist.
  • Significant reduction in hospitalisation observed with clozapine use.
  • High rates of clozapine discontinuation necessitate further investigation into contributing factors.