S Leucht

..Ultimately, strategies to reduce dropout rates are needed...

..Antipsychotic drugs block the transmission of dopamine in the brain and reduce the acute symptoms of the disorder. This review examined whether antipsychotic drugs are also effective for relapse prevention...

..They also have a number of side-effects. Constipation is thought to be common, and a potential serious side-effect, which has received little attention in recent literature...

..The methodological limitations of this review, the generalizability of the results and expectations from future research are discussed...

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..Although the randomized evidence on a superiority of depot compared to oral treatment is not ideal, this approach suggests obvious advantages in assuring compliance...

..However, these drugs are important contributions to treatment, and most psychiatrists, let alone patients, would probably not want to do without them...

..The authors performed a systematic review and meta-analysis of studies of the potential of new-generation antipsychotic drugs to improve adherence and decrease relapse rates in patients with schizophrenia...

..To examine the past and current research into the concepts of remission and recovery in schizophrenia...

..The aim of this study was to undertake a systematic review and meta-analysis of the safety and efficacy of one frequently used adjunctive compound: carbamazepine...

..The purpose of this article was to compare the atypical profile of amisulpride with that of the 5-HT(2)/D(2) antagonists...

..Meanwhile, a preliminary working range of 50 to 250 ng/mL is proposed on the basis of critical reassessment of published data...

..Among the measures that have the potential to improve adherence to medication are psychosocial interventions, psychoeducation in the form of professional, peer-to-peer or family-to-family interventions, and shared decision making...

..Despite the widespread use of the Brief Psychiatric Rating Scale (BPRS), the clinical meaning of its total score and cut-off values used to define treatment response are unclear...

..The authors conducted a systematic review and meta-analysis of blinded studies comparing second-generation antipsychotics head-to-head...

..We conducted a prospective blinded two-center study seeking correlations between CYP2C19 and CYP2D6 genotypes, drug concentrations, adverse events, and therapy response...

..Side effects and weight gain, however, seem to be more influenced by serotonergic polymorphisms...

..Negative symptoms are common in people with schizophrenia and are often difficult to treat with antipsychotic drugs. Treatment often involves the use of various add-on medications such as antidepressants...

..This meta-analysis indicates that psychoeducational interventions are essential to schizophrenia treatment...

..Current knowledge in this young field of research is summarized...

..They estimate that only about 10- 30 % of all patients with schizophrenia receive second-generation antipsychotics, a figure that lies significantly below the international average...

..In the present study, the feasibility and effects of SDM for in-patients with schizophrenia should be evaluated...

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..Meta-analyses addressing the use of SGAs in the treatment of acute mania are lacking...

..Psychotropic drugs are efficacious, but they need to be prudently applied according to evidence-based criteria...

..Thus, not only poor and ultrarapid metabolizer but also IMs may benefit from CYP2D6 genotyping. This is of paramount interest since it greatly improves cost/benefit estimations for pretreatment CYP2D6 screening...

..In the neurosciences a similar trend was seen but the findings were not statistically significant. The reason for this inconclusive finding might be the low number of RCTs published in German...

..Some of the single studies showed inconsistent beneficial effects on some aspects of response, but no overall superiority of valproate augmentation at study endpoints was shown...

..Clinicians seem to base CGI ratings on relative change rather than on absolute change of symptoms...

..Little is known about the desire of patients with schizophrenia to be involved in medical decisions affecting their treatment...

..These may allow a much desired prediction of metabolic activity within the extensive metabolizer group. The functional consequences are still being discussed with few data available for clinical patients...

..g. at least 20% or 50% reduction of the baseline score) are as yet unclear. We therefore compared the PANSS with simultaneous ratings of Clinical Global Impressions (CGI)...

..The combination of antipsychotics and antidepressants may be more effective in treating negative symptoms of schizophrenia than antipsychotics alone, but this finding needs to be corroborated by further large trials...

..Whether methodological issues account in part for the relatively low efficacy ESs and the scarcity of adverse event differences compared with placebo needs to be established...

..In other medical fields, 'shared decision making' (a strategy for including patients in therapeutic decision processes) has been studied for several years now. This survey presents the potential of shared decision making for psychiatry...

..The aim of the present analysis was to study whether shared decision making (SDM) in antipsychotic drug choice would influence long-term outcome...

..To use the degree of response after 2 weeks of treatment to predict non-response at 4 to 6 weeks...

..Accordingly, patients' knowledge of the optimal duration of maintenance therapy was poor...

..The fact that it takes only 1-2 min to fill in the CGI justifies its use in addition to more specific scales in drug trials for schizophrenia. Further development and evaluation of the CGI is warranted...

..We therefore attempted to identify what degree of nonresponse shortly after initiation of antipsychotic drug treatment predicts nonresponse at 4 weeks...

..Further large, well-designed trials are necessary to establish the relative effects of different second generation antipsychotic drugs...

..The main focus was the question of whether the development process of the guidelines followed basic principles of evidence-based medicine...

..Systematic reviews and meta-analyses are increasingly frequently used in the evaluation of medical treatments. This review explains the principles of the methodology, significance and limitations of systematic reviews...

..Criteria for remission in schizophrenia have recently been presented. It is unclear how many acutely ill patients meet these criteria and how they compare with previously suggested definitions...

..A considerable number of patients would accept a depot drug as a long-term treatment option. The gap between patients' acceptance and the low prescription rates can be narrowed by offering antipsychotic depots to more patients...

..Nevertheless, long-acting injectable formulations are seldom prescribed in the treatment of schizophrenia...

..We suggest a table presenting responder rates in 25 percent steps covering the whole range up to 100% reduction from baseline, which could be displayed together with recently presented criteria for remission...

..New standardized criteria for remission in schizophrenia were presented in 2005 which need to be examined in regard to their significance for clinical trials...

..We aimed to establish whether the new drugs induce fewer EPS than low-potency conventional antipsychotics...

..The lifespan of people with schizophrenia is shortened compared to the general population. We reviewed the literature on comorbid physical diseases in schizophrenia to provide a basis for initiatives to fight this unacceptable situation...

..The influence of patient and physician variables on antipsychotic drug choice for patients with schizophrenia was assessed...

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..We attempted to determine the decision rules psychiatrists use in the choice of antipsychotic drugs for inpatients with schizophrenia...

..While most "atypicals" have a high affinity for both dopamine and serotonin receptors, amisulpride has only dopamine receptor action...

..Better training of clinicians in the interpretation of scientific results and the use of more meaningful clinical outcomes are both needed to effectively translate research into clinical practice...

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..The authors present practical examples to highlight the current problems and propose a concrete series of suggestions on how to further optimize antipsychotic drug trials in the future...

..Benefits in the treatment of alcohol dependence might be optimized by matching the efficacy profiles of specific antidipsotropics with the motivational status of alcohol-dependent patients...

..Studies in somatic medicine have demonstrated delays in the implementation of new drugs, but data on psychiatric drugs are scarce. This study examined psychiatrists' adoption of a new antipsychotic...

..Other psychiatrist-related factors (e.g. age, gender, and work experience) did not influence attitudes toward depot...

..Clinicians frequently use lithium to augment antipsychotic medication in schizophrenia. Therefore, we undertook a systematic review and meta-analysis of the use of lithium in the treatment of schizophrenia...

..This research has not been replicated nor examined in individual trials. This study aims to examine the feasibility of extrapolation from the CGI to the PANSS across and within 4 large clinical trials of antipsychotic medication...

..The purpose of this review is to understand how changes in costs of illness are related to the effects of antipsychotic medications on symptoms in schizophrenia patients...

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..This hypothesis was examined in a systematic review of studies involving open or controlled treatment with any second-generation antipsychotic...

..51, P = .009). CONCLUSIONS: Evidence based on a small number of randomized subjects should be interpreted cautiously. Early treatment efficacy of pharmacotherapies is occasionally overestimated...

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..In this issue, Ganguli et al. have carried out a randomized switching study, the data from which indicates the tactics that might be optimal. We put this paper into context, provide a critique and describe indications for switching...

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