Browsing by Subject "risperidone"

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    Low serum levels of brain-derived neurotrophic factor in patients with schizophrenia do not elevate after antipsychotic treatment
    (2004) Pirildar S.; Gönül A.S.; Taneli F.; Akdeniz F.
    Brain-derived neurotrophic factor (BDNF) has been suggested to be involved in the etiology of schizophrenia. There is a line of evidence that disruption of neurotrophins could play a role in the etiology of schizophrenia, and antipsychotics show their effect by altering levels of neurotrophins. The aim of this study was to evaluate the effect of antipsychotics on serum BDNF levels and their relationship with the symptoms in patients with schizophrenia. Twenty-two schizophrenia patients were enrolled in the study. The control group consisted of 22 age- and sex-matched physically and mentally healthy volunteers (7 male, 15 female). Serum BDNF levels and the positive and negative syndrome scale (PANSS) scores were recorded at baseline and after 6 weeks of treatment. Serum BDNF levels were also recorded in the control group. Schizophrenia patients who failed to meet 30% improvement in PANSS score were excluded from the study. The baseline serum BDNF levels of schizophrenia patients were lower than those of controls (t=4.56; df=21; p<0.001). There was no correlation between serum BDNF levels and PANSS scores in patients with schizophrenia (p>0.05). Although PANSS (for positive symptoms p<0.001, for negative symptoms p<0.001) and general psychopathology (t=20.9; df=22; p<0.001) scores improved significantly after 6 weeks of antipsychotic treatment; there was no change in BDNF levels in patients' serum (p>0.05). Our results support the view that BDNF would be associated with schizophrenia. However, we could not conclude that treatment with antipsychotics alters serum BDNF levels in patients with schizophrenia. © 2004 Elsevier Inc. All rights reserved.
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    Mechanism of diabetes related to atypical antipsychotics; [Atipik antipsikotiklere baǧli geliflen diyabetin mekanizmasi]
    (2007) Yurtsever F.; Esen-Danaci A.; Deveci A.
    New researches and case reports have revealed that diabetes incidence is higher in patients treated with new generation antipsychotics. The incidence of diabetes is 2-3 fold in schizophrenic patients compared to normal population. It is confuses that the use of new generation antipsychotics increases the risk of diabetes and cardiovascular diseases related to it. With the use of new generation antipsycotics onset age of diabetes went under 40 years in patients with schizophrenia. Even though the mechanism of diabetes caused by new generation antipsychotics is unclear some hypotheses include mechanisms related with dopamine receptor antagonism, increase in body weight, histamine 1 and 5-HT2A or 5-HT2C receptor antagonism, increase in serum leptin, insulin resistance and direct effects on pancreas. We reviewed the evidence regarding the diabetogenic effects of new generation antipsychotics and possible underlying mechanisms of this effect.
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    The effect of the family history of diabetes on glucose metabolism of the patients recieving atypical antipsychotics; [Atipik antipsikotik kullanan hastalarda ailede diyabet öykü sü olmasinin glukoz metabolizmasi üzerine olan etkisi]
    (2007) Yurtsever F.; Esen-Danaci A.; Taneli F.; Günay Ö.; Veznedaroǧlu B.
    Objective: Diabetes is observed 2-3 times more frequently in schizophrenic patients with comparison to the general population. Recently, many publications have reported diabetes related to atypical antipsychotics. Risk factors such as age, ethnicity, overweight, duration of obesity, physical activity, and family history of diabetes seem to help development of diabetes. This study aims to investigate how the glucose metabolism is affected from familial history of diabetes which is a risk factor for the disease. Method: Seventy patients who have a diagnosis of schizophrenia or other psychotic disorders and are treated with atypical antipsychotics for at least one year were recruited for the study. The patients were divided into two groups defined as those with or without a family history of diabetes. In order to evaluate the glucose metabolism fasting blood glucose, oral glucose tolerance, blood insuline, c-peptide, hemoglobine A1c, leptin and ghrelin levels were measured. Results: The results of the comparison of fasting blood glucose, oral glucose tolerance, blood insuline, c-peptide, hemoglobine A1c, leptin and ghrelin levels between two patient groups with and without family history of diabetesonly ghrelin levels were found to be statistically higher in the group of patients with a history of diabetes in their family; no other parameters have statistically significant differencesbetween two groups. Conclusion: Having a family history of diabetes may increase the probabality of disturbance in glucose metabolism of the patients receiving atypical antipsychotics. It would be reasonable to evaluate the risk factors prior to the treatment and routinely review the parameters required to evaluate the metabolic side effects in clinical follow-ups.
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    Effects of second generation antipsychotics on leptin and ghrelin
    (2008) Esen-Danaci A.; Sarandöl A.; Taneli F.; Yurtsever F.; Özlen N.
    Background: Weight gain is a major side effect of antipsychotic treatment. Some atypical antipsychotic agents have profound effects on weight. Body weight is regulated by a complex system, including both peripheral and central factors. Two of the hormones that seem to play an important role in the regulation of food intake, energy metabolism, and body weight are leptin and ghrelin. Leptin is a mediator of long-term regulation of energy balance, suppressing food intake and thereby inducing weight loss. Ghrelin on the other hand is a fast-acting hormone, seemingly playing a role in meal initiation. In this present study it is aimed to compare the effects of five different atypical antipsychotic medications on leptin and ghrelin. Method: 112 patients who were treated either with clozapine (n = 20), olanzapine (n = 28), risperidone (n = 22), quetiapine (n = 20) or amisulpride (n = 22) as monotherapy for at least one year and age, gender, and body mass index (BMI) matched control group (n = 23) were assessed cross-sectionally. Ghrelin and leptin levels were measured with enzyme-immunoassay. Results: When fasting serum leptin levels were compared between groups, control group had the highest mean value (9.2 ± 6.7) and amisulpride group had the lowest mean value (3.7 ± 2.1) but still there was no statistically significant difference between six groups (F = 1993, p = 0.084). In the comparison of the mean values of fasting serum ghrelin levels there was a statistically significant difference between groups (F = 11,473, p = 0.00). In post-hoc analysis it was seen that the control group had the lowest ghrelin level (194.5 ± 86.8). Quetiapine treated group (378.1 ± 260.4) had similar fasting serum ghrelin levels to control group. All the other antipsychotic treatment groups had significantly higher levels of fasting serum ghrelin compared to control group, highest in amisulpride treated group (597.0 ± 150.0). Conclusion: The weight-gain side effect of atypical antipsychotics can be related with the orexigenic effect of elevated serum ghrelin rather than leptin deficit. Among the five widely used atypical antipsychotics quetiapine is the only one which does not elevate the ghrelin level. © 2008 Elsevier Inc. All rights reserved.
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    Efficacy and tolerability of switching to ziprasidone from olanzapine, risperidone or haloperidol: An international, multicenter study
    (Lippincott Williams and Wilkins, 2009) Alptekin K.; Hafez J.; Brook S.; Akkaya C.; Tzebelikos E.; Ucok A.; Tallawy H.E.; Danaci A.-E.; Lowe W.; Karayal O.N.
    To compare the effectiveness of a switch from haloperidol (N=99), olanzapine (N=82), or risperidone (N=104) to 12 weeks of treatment with 80-160 mg/day ziprasidone in patients with stable schizophrenia or schizoaffective disorder. Stable outpatients with persistent symptoms or troublesome side effects were switched using one of three 1-week taper/switch strategies as determined by the investigator. Efficacy was assessed using the Brief Psychiatric Rating Scale score, Clinical Global Impression, Positive and Negative Symptom Scale, Montgomery-Åsberg Depression Rating Scale, and the Global Assessment of Functioning Scale, and tolerability by using standard measures of weight change, extrapyramidal symptoms, and laboratory findings. Suboptimal efficacy was the primary reason for switching. The preferred switch strategy was immediate discontinuation, and the preferred dosing regimen was 120 mg/day. Completer rates were 68, 60, and 86% in the haloperidol, risperidone, and olanzapine pre-switch groups, respectively. At week 12, a switch to ziprasidone resulted in statistically significant improvement from baseline on the Brief Psychiatric Rating Scale score, Clinical Global Impression- Improvement, Positive and Negative Symptom Scale, and Global Assessment of Functioning scales, reduction in extrapyramidal symptoms and a neutral impact on metabolic parameters. Switch from olanzapine and risperidone resulted in weight reduction and from haloperidol in some weight increase. In conclusion, oral ziprasidone of 80-160 mg/day with food was a clinically valuable treatment option for stable patients with schizophrenia or schizoaffective disorder experiencing suboptimal efficacy or poor tolerability with haloperidol, olanzapine, or risperidone. © 2009 Lippincott Williams & Wilkins, Inc.
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    The relationship between schizophrenia and kavum septum pellucidum: A case study
    (Yerkure Tanitim ve Yayincilik, 2014) Ascibasi K.; Aydin O.; Kuzu D.; Deveci A.
    Septum pellucidum that forming the medial wall of the lateral ventricles, a thin layer is formed by two laminae. Cavum septum pellucidum (CSP), a space between the two leaflets of the septi pellucidi, is thought to be a neurodevelopmental anomaly associated with schizophrenia. In normal fetal development, the formation of septum pellucidum occurs at the same time with the development of the neighboring limbic system structures such as hippocampus, amygdala, corpus callosum, septal nucleus. Therefore, the anatomical differences that are detected in the septum pellucidum may reflect the embryonal development disorders of the adjacent anatomical structures. Several magnetic resonance imaging studies have reported a higher prevalence of enlarged CSP in patients with schizophrenia than in normal subjects. In the literature of psychiatric disorders, CSP is most associated with schizophrenia. Wide CSP may support the neurodevelopmental etiology of schizophrenia. In this report we present a schizophrenia case. And we tried to discuss the patient's clinical appearance and neurocognitive disability.
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    The impact of psychotropic drugs on psychosocial functioning in bipolar disorder; [İki uçlu bozuklukta kullani{dotless}lan ilaçlari{dotless}n psikososyal işlevsellik üzerine etkisi]
    (Cukurova Univ Tip Fakultesi Psikiyatri Anabilim Dali, 2014) Aydemir O.; Cetinay Aydin P.; Gulec Oyeckin D.; Gulseren S.; Putgul Koybasi G.; Sahin H.
    Objective: Even though bipolar patients achieve remission, they do not reach premorbid psychosocial functioning. Factors such as residual depressive symptoms and number of episodes may cause this effect. The impact of treatment modalities has not been adequately studied. The aim of this study was to evaluate the impact of treatment modalities on psychosocial functioning in remitted bipolar patients. Methods: The study was carried out with 108 patients diagnosed as having bipolar disorder. All patients were in remission and the remission state was confirmed by rating scales. In the assessment of functioning, the Functioning Assessment Short Test (FAST) covering domains such as autonomy, occupational functioning, cognitive functioning, financial issues, interpersonal relations, and leisure time activities was applied. The treatment modalities were mood stabilizers (MS) versus mood stabilizers plus second-generation antipsychotics (MS+SGA). While 38% (n=41) of the patients were on MS only, 67 patients (62%) were on MS+SGA. In the statistical analysis, multiple linear regression analysis was performed. Results: In multiple linear regression analyses, the models concerning autonomy, interpersonal relations, and leisure time were statistically significant. In patients on MS+SGA, autonomy (Beta=3.086, p<0.01), interpersonal relations (Beta=2.807, p<0.01) and leisure time activities (Beta=3.293, p<0.01) were affected negatively. Similarly, total HAM-D score had negative effects on the same domains. Conclusion: Beside residual depressive symptoms, second-generation antipsychotics used in the treatment seem to affect psychosocial functioning negatively.
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    Relationship of levetiracetam and obsessive-compulsive disorder: A case report
    (Taylor and Francis Ltd., 2017) Çökmüş F.P.; Aşçıbaşı K.; Öztekin S.; Demet M.M.
    Levetiracetam has gained wide acceptance in the treatment of epilepsy due to its broad-spectrum efficacy, the lack of significant drug–drug interactions, and a relatively benign side effect profile. However, in recent years, the treatment of epilepsy using levetiracetam has been associated with psychiatric side effects such as anxiety, irritability, hostility, depression, hallucinations, and, in some rare cases, obsessive-compulsive disorder. In this case report, we present and discuss onset of obsessive-compulsive disorder symptoms in a 55-year-old epileptic female patient, who did not have any previous psychiatric disorder, including obsessive-compulsive disorder, and who received levetiracetam treatment. © 2017 The Author(s).
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    CADASIL with Atypical Clinical Symptoms, Magnetic Resonance Imaging, and Novel Mutations: Two Case Reports and a Review of the Literature
    (Springer New York LLC, 2019) Sari U.S.; Kisabay A.; Batum M.; Tarhan S.; Dogan N.; Coskunoglu A.; Cam S.; Yilmaz H.; Selcuki D.
    Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary microangiopathy with adult onset caused by a missense mutation in the NOTCH3 gene in chromosome 19p13. It presents with autosomal dominant arteriopathy, subcortical infarctions, and leukoencephalopathy. Its common clinical presentations are seen as recurrent strokes, migraine or migraine-like headaches, progressive dementia, pseudobulbar paralysis, and psychiatric conditions. Two patients with CADASIL syndrome, whose diagnosis was made based on clinical course, age of onset, imaging findings, and genetic assays in the patients and family members, are presented here because of new familial polymorphisms. The first patient, with cerebellar and psychotic findings, had widespread non-confluent hyperintense lesions as well as moderate cerebellar atrophy in cranial magnetic resonance scanning. The other patient, with headache, dizziness, and forgetfulness, had gliotic lesions in both cerebral hemispheres. CADASIL gene studies revealed a new polymorphism in exon 33 in the first patient. In the other patient, the NOTCH3 gene was identified as a new variant of p.H243P (c.728A > C heterozygous). By reporting a family presenting with various clinical symptoms in the presence of new polymorphisms, we emphasize that CADASIL syndrome may present with various clinical courses and should be considered in differential diagnoses. © 2019, Springer Science+Business Media, LLC, part of Springer Nature.
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    Use of Antipsychotics: The Experiences, Views, and Monitoring Practices of Child and Adolescent Psychiatrists in Turkey
    (Mary Ann Liebert Inc., 2021) Çaklr B.; Yalln Sapmaz S.; Kandemir H.
    Objectives: The aim of this study is to evaluate the antipsychotics prescribed by child psychiatrists and their applications on the follow-up of these drugs. Methods: The universe of this research included consultant physicians and child psychiatry residents working in the field. A questionnaire has been created that assesses the use of antipsychotics and follow-up processes of physicians. The survey involved 19 questions. Contents of the survey were sociodemographic data, short-term and long-term follow-up of antipsychotic drugs, side-effect intervention strategies, and diagnoses of the most commonly preferred antipsychotic medications. The survey was delivered via e-mail and sent as a message to the child and adolescent psychiatrists in Turkey. Results: One hundred sixty-one physicians working in the field of child and adolescent psychiatry participated in the study. Aripiprazole (32.2%), risperidone (30.4%), and quetiapine (14.9%) were three most commonly prescribed antipsychotics. Disruptive behavior-related disorders (28.9%), behavior problems related to autism spectrum disorder (20.7%), behavior problems related to intellectual disability (14.5%), and attention-deficit/hyperactivity disorder (12.4%) were the most common diagnoses requiring antipsychotics medications. Before starting antipsychotic treatment, the most commonly evaluated parameters were body mass index (BMI) (47.2%), waist circumference (10.5%), blood pressure (28.5%), lipid profile (37%), and blood glucose level (41.6%). When the evaluations made at least in a year after starting antipsychotic drug therapy were examined, 80.2% of physicians reported blood glucose, 79.6% lipid profile, 65.7% BMI, 59.1% blood pressure, and 26.6% waist circumference measurement almost always done. Conclusions: The results showed that the adherence to recommendations in guidelines for the screening of antipsychotic-related side effects was low. This study suggests that interventions should be made about antipsychotic monitoring training to physicians. © Copyright 2021, Mary Ann Liebert, Inc., publishers 2021.
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    High Depression Symptoms and Burnout Levels Among Parents of Children with Autism Spectrum Disorders: A Multi-Center, Cross-Sectional, Case–Control Study
    (Springer, 2021) Kütük M.Ö.; Tufan A.E.; Kılıçaslan F.; Güler G.; Çelik F.; Altıntaş E.; Gökçen C.; Karadağ M.; Yektaş Ç.; Mutluer T.; Kandemir H.; Büber A.; Topal Z.; Acikbas U.; Giray A.; Kütük Ö.
    The diagnosis of autism spectrum disorder (ASD) in a child affects family processes, increases parenting stress and marital conflicts, and may lead to parental psychopathology. It may also affect the prognosis for their children. The aim of this study is to determine depression and burnout levels as well as their predictors among parents of children with ASD compared with those of healthy children. We also sought to evaluate rate of complementary and alternative medicine (CAM) interventions among parents and explore the associations of this phenomenon in an exploratory fashion. 145 children with ASD and 127 control children were enrolled along with their mothers and fathers. Beck Depression Inventory and Maslach Burnout Inventory were used to evaluate parents’ depression symptoms and burnout levels. Symptoms of children with ASDs were evaluated according to the Childhood Autism Rating Scale by the clinicians. Family, child and CAM variables were screened by means of a sociodemographic data form. Descriptive, bivariate and correlation analyses were used in statistical evaluations. Predictors of burnout were evaluated with multiple regression analysis. Burnout and depression levels among parents of children with ASD were significantly elevated compared to controls. Burnout levels of mothers were significantly elevated compared to fathers while depression scores of fathers were significantly elevated compared to mothers. Maternal burnout was significantly predicted by presence of functional speech in child while paternal burnout was significantly predicted by paternal vocation. Maternal depression was associated with paternal depression, lack of speech in child and attendance of child to special education services. Paternal depression was associated with autistic symptom severity and maternal depression. More than half the parents sought CAM interventions. Education level did not affect search for CAM interventions while both maternal and paternal psychopathology and presence of epilepsy among children increased use of CAM methods. Psychological support should be provided to both mothers and fathers of a child receiving a diagnosis of ASD. Addressing parents’ burnout and stress levels and facilitating their negotiation of knowledge on etiology and treatments for ASD may be beneficial for the family unit as a whole. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.
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    Index depressive episode and antidepressant exposure were associated with illness characteristics of pediatric bipolar disorder
    (John Wiley and Sons Inc, 2022) Inal N.; Ermis C.; Koc D.; Aksoy S.; Karacetin G.; Tuncturk M.; Eray S.; Karabina B.; Faruk Akca O.; Ozgul D.; Gunay Kilic B.; Cikili Uytun M.; Besenek M.; Kavurma C.; Bilac O.; Gokcen C.; Topal Z.; Percinel Yazıcı I.; Sapmaz S.Y.; Ozyurt G.; Diler R.S.
    Objective: Pediatric bipolar disorder (PBD) is a serious, recurrent disorder leading to severe functional impairment. As a first mood episode, index episode could affect the long-term course of the illness. This study aimed to investigate the clinical characteristics of youth with PBD from our multicenter, nationwide, naturalistic follow-up samples and to identify (i) the effects of index mood episode and (ii) the effect of previous antidepressant treatments on the age at mania onset of PBD. Method: The study sample consisted of 271 youth with BD-I followed by the child and adolescent psychiatry clinics of seven different university hospitals and three research state hospitals, representing six geographic regions across Turkey. All diagnoses were made according to structured interviews, and all data were retrospectively obtained from clinical records by the clinicians. Results: When patients with index depressive/mixed episodes (IDE, n=129) and patients with index (hypo)manic episodes (IME, n=142) were compared, the total number of mood episodes and rapid cycling feature were significantly higher in the IDE group than in the IME group. The Cox regression analysis adjusted for sociodemographic and illness characteristics revealed female adolescents in the IDE group treated with antidepressants were more likely to have an earlier onset of mania (hazard ratio=2.03, 95% confidence interval=1.31–3.12, p=0.001). Conclusion: This is the first large-scale nationwide follow-up study in Turkey that indicated prior antidepressant treatments were associated with an earlier onset of mania in youth, particularly in adolescent females. Larger prospective studies are needed to identify neurodevelopmental processes underlying PBD and initiate prevention approaches. © 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd