Search

Objective: Here we retrospectively examined regarding predictive factors for lemborexant treatment adherence. Methods: We used the Cox proportional hazards regression model with lemborexant adherence period as the dependent variable and the patient characteristics of age, gender, the duration of benzodiazepine hypnotics use, diazepam equivalent dose of benzodiazepine hypnotics before switching to lemborexant, diazepam equivalent of combined use of benzodiazepine hypnotics, lemborexant dose, Athens Insomnia Scale (AIS) total score before lemborexant administration, AIS score change, and Global Assessment of Functioning (GAF) score. Results: We analyzed 150 (male/female; 57/93) in total. Because 21 patients stopped taking lemborexant due to improved insomnia, they were excluded from the continuation rate analysis. We found that lemborexant dose, AIS total score before lemborexant administration, and GAF, all significantly affected lemborexant continuation duration (p < 0.01; p < 0.05: p < 0.01, respectively). Conclusions: We specifically examined the factors affecting the treatment adherence rate of lemborexant, and the results suggested that it may be improved if the insomnia is less severe before lemborexant administration and the degree of improvement in social functioning level is higher when the lemborexant dose is increased. [ABSTRACT FROM AUTHOR]

Objective: The relationship between the plasma concentration of risperidone or paliperidone and efficacy, the extrapyramidal symptoms (EPS), and quality of life (QOL) was investigated in the same patients with schizophrenia. Methods: 30 patients with schizophrenia currently receiving risperidone were switched to PAL. During treatment with risperidone and paliperidone, their efficacy was assessed using Clinical Global Impression-Severity/Change (CGI-S/CGI-C), and their EPS were assessed using the Abnormal Involuntary Movement Scale (AIMS) and the Barnes Akathisia Scale (BAS), and their QOL was assessed using the Euro-QOL (EQ-5D) scale. Plasma concentrations were measured by the liquid chromatography-mass spectrometry/mass spectrometry method. Results: There were significant correlations between the plasma concentration of active moiety (risperidone plus 9-hydroxy risperidone) and the AIMS and BARS scores (p < 0.05). Although there was a significant correlation between the plasma concentration of paliperidone and the CGI-C, there was no correlation between the plasma concentration of paliperidone and the AIMS or BARS scores. Furthermore, although there was a significant correlation between the plasma concentration of paliperidone and the EQ-5D utility score (p < 0.05), there was no correlation between the plasma concentration of the active moiety and the EQ-5D utility score. Conclusion: The results of this study reveal that in contrast to risperidone, when there is a switching from risperidone to paliperidone, increases in the paliperidone concentration were less likely to result in an increase of EPS, but correlated to the CGI-C and EQ-5 utility score, suggesting that paliperidone may contribute to improvement in efficacy and QOL with dose increase. [ABSTRACT FROM AUTHOR]

Objective: This study examines gender differences in plasma paliperidone concentration in patients with schizophrenia following a 12-week course of paliperidone treatment. Methods: The measurement of plasma paliperidone concentration was performed using the liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) method. Results: There was no significant difference in the mean plasma paliperidone concentration, 31.3 ± 26.4 (ng/ml) and 50.5 ± 32.8 (ng/ml), for men and women, respectively. Conclusion: The plasma concentration of paliperidone is higher in women than in men; consequently, adverse events are more likely to occur. Therefore, gender differences need to be considered when deciding prescription doses of paliperidone. [ABSTRACT FROM AUTHOR]

Objective: We report that in one patient with bipolar disorder with sodium valproate-associated hyperammonemia. Methods: Administration of both acetyl-L-carnitine (ALC) and sodium valproate (VPA) was stopped. Results: The blood ammonia levels after 6 weeks of ALC therapy were showing almost no decline. VPA was gradually tapered and then stopped. Two weeks after stopping VPA, the blood ammonia level dropped, and was normalized. Conclusion: When a patient presents with hyperammonemia associated with VPA administration, our results suggest that when no effects are identified with ALC supplementation therapy, tapering or stopping VPA administration, or changing to other mood stabilizers or antipsychotics are options that must be considered. [ABSTRACT FROM AUTHOR]

Objective: This study examines gender differences in plasma risperidone concentration in patients with schizophrenia under risperidone treatment. Methods: The measurement of plasma risperidone concentration was performed using the liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) method. Results: There was no significant difference in the mean plasma active moiety concentration of risperidone, 37.0 ± 17.0 (ng/ml) and 48.2 ± 131.4 (ng/ml) for men and women, respectively. Conclusion: The results of this study demonstrated that plasma active moiety concentration of risperidone in women is higher than that in men, though this difference is not significant. Therefore, gender differences need to be considered when deciding prescription doses of risperidone. [ABSTRACT FROM AUTHOR]

Objective: We report on the benefits associated with switching from benzodiazepine hypnotics to suvorexant in elderly major depressive patients with mild insomnia. Methods: Insomnia was assessed using the Athens Insomnia Scale (AIS). Results: As a result of switching from benzodiazepine hypnotics to suvorexant in the present patient, the AIS remained hardly unchanged. Conclusion: These results indicate that switching from benzodiazepine hypnotics to suvorexant in elderly major depressive patients with mild insomnia can free the patient from some problematic side effects of pharmacological treatment. [ABSTRACT FROM AUTHOR]

Objective: We report the case of a woman patient with schizophrenia who lactated during aripiprazole once-monthly 300 mg (AOM 300) maintenance therapy of more than one year. Methods: We checked pregnancy history, menstrual irregularities, and prolactin levels. Results: In the present patient, there were no abnormalities in previous pregnancies, menstrual irregularities or prolactin levels after AOM 300 treatment, but lactation occurred after 78 weeks of AOM 300 treatment. The prolactin level was estimated to be 17.2 (mg/ml), which was within the physiological range. On consultation with the Department of Breast Surgery, the condition was diagnosed as mastopathy after detailed examination; hence, the effect of the pharmacotherapeutic agent was ruled out and AOM 300 treatment was continued thereafter. Conclusion: These results suggest the necessity of deciding whether to continue AOM treatment when lactation occurs during AOM treatment, after checking the age of the patient and ascertaining if they have hyperprolactinemia. A possible adverse reaction to AOM should also be suspected and the Department of Breast Surgery should be consulted for careful investigation into the possibility of mastopathy, breast cancer, and other diseases. [ABSTRACT FROM AUTHOR]