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Antibiotic affecting risperidone and venlafaxine concentrations
Psychiatric patients often have concurrent medical conditions that require management with pharmacotherapy, thereby increasing the potential for drug‐drug interactions. The following case involved an occurrence of increased risperidone and venlafaxine concentrations and a change in the metabolic ratios between the parent compound and the respective metabolite after the antibiotic metronidazole was added to an ongoing regimen of both psychotropics. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - July 19, 2017 Category: Psychiatry Authors: Y. W. Francis Lam Tags: Drug ‐Drug Interactions Source Type: research

Regulating pharmaceutical sales visits to doctors slows prescribing of detailed drugs
Most of a group of academic medical centers that imposed restrictions on pharmaceutical sales visits to physicians between 2006 and 2012 saw a significant decrease in prescribing of drugs that are detailed by the drug makers, a new study has found. This was the case for six of eight drug classes included in the analysis, although antipsychotics were one of the two classes where significant decreases were not seen. Study results were published in the May 2 issue of JAMA. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - July 19, 2017 Category: Psychiatry Tags: Industry Trends Source Type: research

Phase 3 study finds once ‐daily valbenazine improves symptoms of tardive dyskinesia
Once‐daily dosing of the vesicular monoamine transporter 2 (VMAT2) inhibitor valbenazine resulted in significant improvement over placebo in patients with tardive dyskinesia (TD) and an underlying psychotic or mood disorder, a Phase 3 trial has found. Soon after the study's publication online March 21 in the American Journal of Psychiatry, the Food and Drug Administration approved valbenazine as the first available treatment for TD (see From the FDA, page 8). (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - June 16, 2017 Category: Psychiatry Tags: Adverse Events Source Type: research

Approvals
(Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - June 16, 2017 Category: Psychiatry Tags: From the FDA Source Type: research

Research Roundup
Concurrent use of benzodiazepines, opioids exacerbates overdose risk Combination of supplements reduces vulnerability to postpartum depression Supplements show no effect on prevention of dementia Augmenting ECT with ketamine fails to achieve cognitive benefit Diabetic peripheral neuropathy pain treatments require longer‐term analysis (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - June 16, 2017 Category: Psychiatry Tags: Research Roundup Source Type: research

Sodium valproate shown most effective as augmentation for clozapine
A meta‐analysis encompassing trials of four antiepileptic drugs used to augment clozapine therapy for treatment‐resistant schizophrenia has concluded that use of sodium valproate offers a safe and effective approach. Use of topiramate was associated with a high rate of treatment discontinuation, the researchers reported. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - June 16, 2017 Category: Psychiatry Tags: What's New in Research Source Type: research

Use of medications for enlarged prostate not associated with suicide risk
A Canadian study of older men who took a 5‐alpha‐reductase inhibitor (5ARI) for the treatment of benign prostatic hyperplasia (BPH) has found no increased risk of suicide compared with men not receiving the medication. Risk of self‐harm and depression was greater in the medicated group during the first 18 months of treatment, however. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - June 16, 2017 Category: Psychiatry Tags: What's New in Research Source Type: research

Mood stabilizers and risperidone
The atypical antipsychotic risperidone is recommended as augmentation therapy to mood stabilizers for the management of patients with bipolar disorder. Antiepileptic drugs, such as lamotrigine, carbamazepine, and valproic acid, also are commonly used for management of various psychiatric disorders, including bipolar disorder. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - June 16, 2017 Category: Psychiatry Authors: Y. W. Francis Lam Tags: Drug ‐Drug Interactions Source Type: research

Matching to preferred depression treatment does not improve likelihood of remission
A study designed to identify predictors of treatment outcome in patients with depression has found that while patients who were matched to their preferred treatment were more likely to complete the study, they were no more likely to achieve remission of symptoms. Despite this finding, the researchers suggested that asking patients whether they prefer medication or behavioral therapy for their depression can reveal beneficial information. Study results were published online March 24 in the American Journal of Psychiatry. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - June 16, 2017 Category: Psychiatry Tags: Depression Treatment Source Type: research

Consensus statement urges caution in using ketamine for treating depression
With ketamine infusion therapy generating significant interest for the treatment of mood disorders despite a lack of evidence from large‐scale trials, a subgroup of an American Psychiatric Association (APA) task force has issued a consensus statement on critical issues to consider in this off‐label use of ketamine. Among the statement's recommendations are that the number of ketamine treatments should be limited to the minimum necessary to achieve response and that providers should assess for the patient's potential to develop a ketamine use disorder. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - May 19, 2017 Category: Psychiatry Tags: Depression Treatment Source Type: research

Research Roundup
Year of testosterone treatment fails to improve cognition in older men Genetic variants linked to heart defects in children of women taking SSRIs Postmenopausal hormone therapy not highly protective for Alzheimer's disease Polypharmacy in older adults soars, particularly for pain patients Prevalent use of other opioids found in buprenorphine patients Low‐cost medication reminder devices fail to improve drug adherence (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - May 19, 2017 Category: Psychiatry Tags: Research Roundup Source Type: research

Lithium more effective than quetiapine in patients with first ‐episode mania
A study of 41 patients with stabilized first‐episode bipolar mania has found that maintenance treatment with lithium was more effective than quetiapine treatment on a number of symptoms over a one‐year period. The results were surprising in that they contradicted prior studies that had found no significant difference between mood stabilizers and atypical antipsychotics in maintenance treatment. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - May 19, 2017 Category: Psychiatry Tags: What's New in Research Source Type: research

Cariprazine more effective than risperidone for negative symptoms of schizophrenia
In what is believed to be the first large‐scale study demonstrating improvement in negative symptoms of schizophrenia from an antipsychotic monotherapy, patients receiving cariprazine over 26 weeks saw greater improvement than patients receiving risperidone. Given the lack of treatment options for schizophrenia patients with predominantly negative symptoms, the findings of this study could carry significant implications for clinical practice, the researchers stated. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - May 19, 2017 Category: Psychiatry Tags: What's New in Research Source Type: research

Risperidone and low ‐potency antipsychotics
Patients with schizophrenia often experience anxiety, agitation, and sleep disturbances, and concurrent use of a benzodiazepine is a common practice in their pharmacological management. However, this polypharmacy practice is associated with the risk of dependence, withdrawal, and symptom recurrence upon stopping the benzodiazepine. Adding a low‐potency antipsychotic, such as pipamperone, has been proposed as an alternate strategy to avoid these risks, as well as having the potential for amplified dopaminergic and noradrenergic blockade and sedative effect. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - May 19, 2017 Category: Psychiatry Authors: Y. W. Francis Lam Tags: Drug ‐Drug Interactions Source Type: research

Flawed reviews of pediatric depression studies underestimate medication effects
Previous reviews of antidepressant treatment for children and adolescents that found minimal or no positive effects failed to account for critical methodological differences in studies, a new review concludes. The author of the review, published March 3 in the American Journal of Psychiatry, states that earlier reviews have drawn questionable conclusions because they categorized many flawed pharmaceutical industry–sponsored trials that found no benefits from antidepressants as negative trials, rather than as failed trials. Accounting for this distinction leads the author of the present paper to conclude that evidence for...
Source: The Brown University Psychopharmacology Update - May 19, 2017 Category: Psychiatry Tags: Pediatric Treatment Source Type: research