Advances in the Treatment of Schizophrenia

A special issue of Neurology International (ISSN 2035-8377).

Deadline for manuscript submissions: closed (28 February 2022) | Viewed by 32842

Special Issue Editors


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Guest Editor
Department of Pharmacy Practice, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA 95207, USA
Interests: Pharmacy; Anesthesia; Pain Management; Pain Medicine; Memory; Chronic Pain; Drugs; Pain Assessment; Pain Measurement; Pain Perception

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Guest Editor
Department of Psychiatry and Behavioral Medicine, LSU Health Shreveport, Shreveport, LA 71103, USA
Interests: Psychiatry; Addiction; Antipsychotics; Psychotic Disorders; Women’s mental health

Special Issue Information

Dear Colleagues,

Schizophrenia remains one of the most serious clinical conditions. It is associated with a chronic relapsing course and pronounced cognitive dysfunction in a large proportion of patients, despite therapeutic advancements over the past few decades. This Special Issue will provide a review of recent and historial research in the field of schizophrenia pharmacology and therapeutics. Furthermore, this issue will consider the mechanisms underlying schizophrenia development and progression, symptomatic improvement, improving adherence to pharmacologic treatment  and the treatment of side effects to allow personalized care.

Prof. Dr. Adam M. Kaye
Dr. Amber Edinoff
Guest Editors

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Keywords

  • dopamine antagonism
  • serotonergic modulation
  • adherence and compliance
  • mood stabilizers

Published Papers (4 papers)

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Review

16 pages, 606 KiB  
Review
Antipsychotic Polypharmacy-Related Cardiovascular Morbidity and Mortality: A Comprehensive Review
by Amber N. Edinoff, Emily D. Ellis, Laura M. Nussdorf, Taylor W. Hill, Elyse M. Cornett, Adam M. Kaye and Alan D. Kaye
Neurol. Int. 2022, 14(1), 294-309; https://0-doi-org.brum.beds.ac.uk/10.3390/neurolint14010024 - 17 Mar 2022
Cited by 6 | Viewed by 3146
Abstract
Schizophrenia is a psychotic disorder that exists at the more extreme end of a spectrum of diseases, and significantly affects daily functioning. Cardiovascular adverse effects of antipsychotic medications are well known, and include changes in blood pressure and arrhythmias. Sudden cardiac death is [...] Read more.
Schizophrenia is a psychotic disorder that exists at the more extreme end of a spectrum of diseases, and significantly affects daily functioning. Cardiovascular adverse effects of antipsychotic medications are well known, and include changes in blood pressure and arrhythmias. Sudden cardiac death is the leading cause of death worldwide, and antipsychotic medications are associated with numerous cardiac side effects. A possible link exists between antipsychotic medications and sudden cardiac death. Common prescribing patterns that may influence cardiovascular events include the use of multiple antipsychotics and/or additional drugs commonly prescribed to patients on antipsychotics. The results of this review reflect an association between antipsychotic drugs and increased risk of ventricular arrhythmias and sudden cardiac death by iatrogenic prolongation of the QTc interval. QTc prolongation and sudden cardiac death exist in patients taking antipsychotic monotherapy. The risk increases for the concomitant use of specific drugs that prolong the QTc interval, such as opioids, antibiotics, and illicit drugs. However, evidence suggests that QTc intervals may not adequately predict sudden cardiac death. In considering the findings of this narrative review, we conclude that it is unclear whether there is a precise association between antipsychotic polypharmacy and sudden cardiac death with QTc interval changes. The present narrative review warrants further research on this important potential association. Full article
(This article belongs to the Special Issue Advances in the Treatment of Schizophrenia)
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13 pages, 305 KiB  
Review
Antipsychotic Use in Pregnancy: Patient Mental Health Challenges, Teratogenicity, Pregnancy Complications, and Postnatal Risks
by Amber N. Edinoff, Niroshan Sathivadivel, Shawn E. McNeil, Austin I. Ly, Jaeyeon Kweon, Neil Kelkar, Elyse M. Cornett, Adam M. Kaye and Alan D. Kaye
Neurol. Int. 2022, 14(1), 62-74; https://0-doi-org.brum.beds.ac.uk/10.3390/neurolint14010005 - 03 Jan 2022
Cited by 12 | Viewed by 9404
Abstract
Pregnant women constitute a vulnerable population, with 25.3% of pregnant women classified as suffering from a psychiatric disorder. Since childbearing age typically aligns with the onset of mental health disorders, it is of utmost importance to consider the effects that antipsychotic drugs have [...] Read more.
Pregnant women constitute a vulnerable population, with 25.3% of pregnant women classified as suffering from a psychiatric disorder. Since childbearing age typically aligns with the onset of mental health disorders, it is of utmost importance to consider the effects that antipsychotic drugs have on pregnant women and their developing fetus. However, the induction of pharmacological treatment during pregnancy may pose significant risks to the developing fetus. Antipsychotics are typically introduced when the nonpharmacologic approaches fail to produce desired effects or when the risks outweigh the benefits from continuing without treatment or the risks from exposing the fetus to medication. Early studies of pregnant women with schizophrenia showed an increase in perinatal malformations and deaths among their newborns. Similar to schizophrenia, women with bipolar disorder have an increased risk of relapse in antepartum and postpartum periods. It is known that antipsychotic medications can readily cross the placenta, and exposure to antipsychotic medication during pregnancy is associated with potential teratogenicity. Potential risks associated with antipsychotic use in pregnant women include congenital abnormalities, preterm birth, and metabolic disturbance, which could potentially lead to abnormal fetal growth. The complex decision-making process for treating psychosis in pregnant women must evaluate the risks and benefits of antipsychotic drugs. Full article
(This article belongs to the Special Issue Advances in the Treatment of Schizophrenia)
17 pages, 348 KiB  
Review
Catatonia: Clinical Overview of the Diagnosis, Treatment, and Clinical Challenges
by Amber N. Edinoff, Sarah E. Kaufman, Janice W. Hollier, Celina G. Virgen, Christian A. Karam, Garett W. Malone, Elyse M. Cornett, Adam M. Kaye and Alan D. Kaye
Neurol. Int. 2021, 13(4), 570-586; https://0-doi-org.brum.beds.ac.uk/10.3390/neurolint13040057 - 08 Nov 2021
Cited by 36 | Viewed by 14631
Abstract
Catatonia is a syndrome that has been associated with several mental illness disorders but that has also presented as a result of other medical conditions. Schizophrenia and other psychiatric disorders such as mania and depression are known to be associated with catatonia; however, [...] Read more.
Catatonia is a syndrome that has been associated with several mental illness disorders but that has also presented as a result of other medical conditions. Schizophrenia and other psychiatric disorders such as mania and depression are known to be associated with catatonia; however, several case reports have been published of certain medical conditions inducing catatonia, including hyponatremia, cerebral venous sinus thrombosis, and liver transplantation. Neuroleptic Malignant Syndrome and anti-NMDA receptor encephalitis are also prominent causes of catatonia. Patients taking benzodiazepines or clozapine are also at risk of developing catatonia following the withdrawal of these medications—it is speculated that the prolonged use of these medications increases gamma-aminobutyric acid (GABA) activity and that discontinuation may increase excitatory neurotransmission, leading to catatonia. The treatment of catatonia often involves the use of benzodiazepines, such as lorazepam, that can be used in combination therapy with antipsychotics. Definitive treatment may be found with electroconvulsive therapy (ECT). Aberrant neuronal activity in different motor pathways, defective neurotransmitter regulation, and impaired oligodendrocyte function have all been proposed as the pathophysiology behind catatonia. There are many clinical challenges that come with catatonia and, as early treatment is associated with better outcomes, it becomes imperative to understand these challenges. The purpose of this manuscript is to provide an overview of these challenges and to look at clinical studies regarding the pathophysiology, diagnosis, and treatment of as well as the complications and risk factors associated with catatonia. Full article
(This article belongs to the Special Issue Advances in the Treatment of Schizophrenia)
16 pages, 358 KiB  
Review
Paliperidone to Treat Psychotic Disorders
by Hormazd D. Minwalla, Peter Wrzesinski, Allison Desforges, Joshua Caskey, Brittany Wagner, Patrick Ingraffia, James C. Patterson II, Amber N. Edinoff, Adam M. Kaye, Alan D. Kaye, Omar Viswanath and Ivan Urits
Neurol. Int. 2021, 13(3), 343-358; https://0-doi-org.brum.beds.ac.uk/10.3390/neurolint13030035 - 28 Jul 2021
Cited by 5 | Viewed by 4656
Abstract
Purpose of Review: This is a comprehensive review of the literature regarding the use of paliperidone in the treatment of schizophrenia and schizoaffective disorder. It covers the background and presentation of schizophrenia and schizoaffective disorder, as well as the mechanism of action and [...] Read more.
Purpose of Review: This is a comprehensive review of the literature regarding the use of paliperidone in the treatment of schizophrenia and schizoaffective disorder. It covers the background and presentation of schizophrenia and schizoaffective disorder, as well as the mechanism of action and drug information for paliperidone. It covers the existing evidence of the use of paliperidone for the treatment of schizophrenia and schizoaffective disorder. Recent Findings: Schizophrenia and schizoaffective disorder lead to significant cognitive impairment. It is thought that dopamine dysregulation is the culprit for the positive symptoms of schizophrenia and schizoaffective disorder. Similar to other second-generation antipsychotics, paliperidone has affinity for dopamine D2 and serotonin 5-HT2A receptors. Paliperidone was granted approval in the United States in 2006 to be used in the treatment of schizophrenia and in 2009 for schizoaffective disorder. Summary: Schizophrenia and schizoaffective disorder have a large impact on cognitive impairment, positive symptoms and negative symptoms. Patients with either of these mental illnesses suffer from impairments in everyday life. Paliperidone has been shown to reduce symptoms of schizophrenia and schizoaffective disorder. Full article
(This article belongs to the Special Issue Advances in the Treatment of Schizophrenia)
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