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Efficacy and dropout rates of antipsychotic medications for methamphetamine psychosis: A systematic review and network meta-analysis. Drug Alcohol Depend 2021; 219:108467. [PMID: 33385693 DOI: 10.1016/j.drugalcdep.2020.108467] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/20/2020] [Accepted: 11/28/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND This study aimed to compare the treatment effects of different antipsychotics for methamphetamine psychosis (MAP). METHODS Clinical Trials, Cochrane Library, Pubmed, Scopus, and Web of Science were searched for short-term, randomized controlled trials (RCTs) from the inception to June 15, 2020. Standardized mean differences (SMDs) and odds ratios (ORs) were aggregated using random-effects pairwise comparisons and frequentist network meta-analyses (NMAs). Primary outcomes of interest were the main psychotic symptoms and dropout rates. We also rated the quality of NMA estimates. RESULTS This NMA included six RCTs of 395 patients with MAP. Six studied antipsychotics were aripiprazole, haloperidol, olanzapine, paliperidone extended-release, quetiapine, and risperidone. Risperidone is the most frequently studied antipsychotic, being investigated in four trials. Low quality of evidence was available to determine the efficacy of those antipsychotics for main psychotic symptoms. Aripiprazole was significantly inferior to olanzapine (SMD = 1.36, 95 % CI = 0.46-2.26), quetiapine (SMD = 1.13, 95 % CI = 0.28-1.98), haloperidol (SMD = 0.87, 95 % CI = 0.14-1.60), and paliperidone extended-release (SMD = 0.60, 95 % CI = 0.06-1.14). Olanzapine and quetiapine were superior to risperidone (SMD = -1.09, 95 % CI = -1.89 to -0.28 and SMD = -0.86, 95 % CI = -1.61 to -0.11, respectively). The dropout rates were not significantly different among the studied antipsychotics. CONCLUSIONS This analysis suggests that olanzapine or quetiapine may be a preferred antipsychotic for MAP, although the evidence for this was rated low-quality due to the high risk of bias or indirectness/intransitivity.
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Jaffett VA, Nerurkar A, Cao X, Guzei IA, Golden JE. Telescoped synthesis of C3-functionalized (E)-arylamidines using Ugi-Mumm and regiospecific quinazolinone rearrangements. Org Biomol Chem 2019; 17:3118-3128. [PMID: 30730519 DOI: 10.1039/c9ob00073a] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
An efficient four-step, six-transformation protocol was developed to afford bioactive N-alkyl- or N-arylamide (E)-arylamidines featuring strategic amidine C3 modifications which were inaccessible or low yielding by previous methods. This synthetic approach, exemplified with 24 amidines and requiring only a single purification, highlights a multicomponent Ugi-Mumm rearrangement to afford highly diversified quinazolinones which undergo regiospecific rearrangement to afford new amidines. The method extensively broadens the structural scope of this new class of trisubstituted amidines and demonstrates the tolerance of regional C3 amidine steric bulk, visualized with X-ray crystallographic analysis.
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Affiliation(s)
- Victor A Jaffett
- Department of Chemistry, University of Wisconsin, 1101 University Ave., Madison, WI 53706, USA.
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Palma-Álvarez RF, Ros-Cucurull E, Ramos-Quiroga JA, Roncero C, Grau-López L. Cocaine-Induced Psychosis and Asenapine as Treatment: A Case Study. PSYCHOPHARMACOLOGY BULLETIN 2019; 49:92-97. [PMID: 30858643 PMCID: PMC6386431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Cocaine-induced psychotic disorder (CIPD) is one of the most serious consequences of cocaine use. Despite the high frequency of CIPD, specific treatment for CIPD has been scarcely researched. Although supportive measures are the first approach, antipsychotic use is often necessary due to clinical severity and CIPD consequences. We report a 38-years-old man with substance use disorders in methadone maintenance treatment who relapsed on cocaine use and presented CIPD that was satisfactorily treated with asenapine. It is important further research on CIPD management, especially on asenapine and other second-generation antipsychotics du to its possible role in its treatment.
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Affiliation(s)
- Raul Felipe Palma-Álvarez
- Palma-Álvarez, MD, Ros-Cucurull, MD, PhD, Ramos-Quiroga, MD, PhD, Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain and Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain. Roncero, MD, PhD, Psychiatry Service. University of Salamanca Health Care Complex, Institute of Biomedicine. University of Salamanca. Spain. Grau-López, MD, PhD, Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain and Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Elena Ros-Cucurull
- Palma-Álvarez, MD, Ros-Cucurull, MD, PhD, Ramos-Quiroga, MD, PhD, Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain and Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain. Roncero, MD, PhD, Psychiatry Service. University of Salamanca Health Care Complex, Institute of Biomedicine. University of Salamanca. Spain. Grau-López, MD, PhD, Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain and Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Palma-Álvarez, MD, Ros-Cucurull, MD, PhD, Ramos-Quiroga, MD, PhD, Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain and Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain. Roncero, MD, PhD, Psychiatry Service. University of Salamanca Health Care Complex, Institute of Biomedicine. University of Salamanca. Spain. Grau-López, MD, PhD, Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain and Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Carlos Roncero
- Palma-Álvarez, MD, Ros-Cucurull, MD, PhD, Ramos-Quiroga, MD, PhD, Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain and Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain. Roncero, MD, PhD, Psychiatry Service. University of Salamanca Health Care Complex, Institute of Biomedicine. University of Salamanca. Spain. Grau-López, MD, PhD, Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain and Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Lara Grau-López
- Palma-Álvarez, MD, Ros-Cucurull, MD, PhD, Ramos-Quiroga, MD, PhD, Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain and Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain. Roncero, MD, PhD, Psychiatry Service. University of Salamanca Health Care Complex, Institute of Biomedicine. University of Salamanca. Spain. Grau-López, MD, PhD, Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain and Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
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Fluyau D, Mitra P, Lorthe K. Antipsychotics for Amphetamine Psychosis. A Systematic Review. Front Psychiatry 2019; 10:740. [PMID: 31681046 PMCID: PMC6804571 DOI: 10.3389/fpsyt.2019.00740] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 09/16/2019] [Indexed: 12/20/2022] Open
Abstract
Background: Among individuals experiencing amphetamine psychosis, it may be difficult to rule out schizophrenia. The use of antipsychotics for the treatment of amphetamine psychosis is sparse due to possible side effects. Some arguments disfavor their use, stating that the psychotic episode is self-limited. Without treatment, some individuals may not fully recover from the psychosis and may develop full-blown psychosis, emotional, and cognitive disturbance. This review aims to investigate the clinical benefits and risks of antipsychotics for the treatment of amphetamine psychosis. Methods: Electronic search on trials on antipsychotic drugs for amphetamine psychosis from their inception to November 2018 was conducted in PubMed, Scopus, Google Scholar, EBSCOhost, ProQuest, Cochrane Review Database, Medline Ovid, and EMBASE following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The Cochrane risk-of-bias tool assessed the risk of bias, the methodological quality of individual trials was assessed by the Oxford Quality Scoring System, and the quality of evidence for recommendations was judged by the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). The results were synthesized qualitatively and quantitatively. Results: The investigation of six randomized controlled trials of 314 participants showed that aripiprazole, haloperidol, quetiapine, olanzapine, and risperidone were able to reduce or control the psychotic episode (positive and negative symptoms) induced by amphetamine use with no adverse event. Although the side-effect profile of these agents varied, no drug was clinically superior to others. Conclusions: This review suggests that antipsychotics seem to be efficacious for amphetamine psychosis on both positive and negative symptoms. Practitioners need to tailor their use based on risks for side effects individually.
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Affiliation(s)
- Dimy Fluyau
- School of Medicine, Emory University, Atlanta, GA, United States
| | - Paroma Mitra
- Langone Health, Department of Psychiatry, NYU, New York, NY, United States
| | - Kervens Lorthe
- Department of Health, Miami Regional University, Miami Springs, FL, United States
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