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Related Concept Videos

Drug Therapy01:28

Drug Therapy

47
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.
Antianxiety Medications
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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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Rational Dosage Regimen: Maintenance Dose and Loading Dose01:24

Rational Dosage Regimen: Maintenance Dose and Loading Dose

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A rational dosage regimen considers a drug's pharmacokinetics, including its absorption, distribution, metabolism, and elimination from the body. By understanding these factors, the appropriate dosage can be determined, and the dosing schedule can be designed to achieve and maintain the desired therapeutic effect while minimizing adverse effects.
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Dosage Regimen: Fixed Dose01:01

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Fixed-dose regimens are a common approach to administer drugs to achieve and maintain desired levels of the drug in the body. In this dosing strategy, a specific amount of medication is given at regular intervals, often multiple times a day, to ensure a consistent drug concentration in the bloodstream.
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
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Psychosis and Antipsychotic Drugs: Overview01:28

Psychosis and Antipsychotic Drugs: Overview

290
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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Drug Dosage Regimen: Overview01:15

Drug Dosage Regimen: Overview

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A drug dosage regimen describes the specific instructions and schedule for administering a drug to a patient. It considers factors such as drug dosage, frequency, route of administration, and duration of treatment. Designing an appropriate dosage regimen for a patient aims to achieve a target drug concentration at the site of action.
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Second International Consensus Study of Antipsychotic Dosing (ICSAD-2).

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Expert consensus provides clinically equivalent dose estimates and dosing recommendations for antipsychotic drugs, aiding clinical practice and research for psychosis treatment. This study updated recommendations for 44 oral, 16 long-acting injectable, and 14 short-acting injectable formulations.

Keywords:
AntipsychoticsDelphi surveyconsensusdosing scheduleschizophreniatherapeutic equivalency

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Area of Science:

  • Psychopharmacology
  • Clinical Psychiatry
  • Drug Dosing

Background:

  • Expert consensus on clinically equivalent doses supports the use of antipsychotic drugs in clinical practice and research.
  • Antipsychotic dosing recommendations are crucial for effective treatment of psychosis.

Purpose of the Study:

  • To provide updated dosing equivalencies and recommendations for newer antipsychotic drugs.
  • To establish consensus on dosing for 44 oral, 16 long-acting injectable (LAI), and 14 short-acting injectable (SAI) formulations.

Main Methods:

  • A two-step Delphi survey process involving 72 international experts from 24 countries.
  • Establishment of consensus on dosing recommendations (start, target range, maximum) and equivalent doses for schizophrenia treatment.
  • Utilized oral olanzapine and intramuscular haloperidol as reference agents for dose equivalency estimates.

Main Results:

  • Consensus improved across survey stages, with the highest agreement for LAI formulations, followed by oral agents, and lowest for SAI formulations.
  • Provided updated equivalency estimates and dosing recommendations for a comprehensive list of antipsychotic drugs.
  • 72 experts provided data on oral, LAI, and SAI formulations.

Conclusions:

  • Expert consensus serves as a valuable alternative for estimating clinical dosing equivalents due to the rarity of fixed-dose trials.
  • The findings support clinical practice, guideline development, and research involving antipsychotic medications.
  • Updated dosing information aids in optimizing the treatment of psychosis.