Antipsychotic drug-aripiprazole against schizophrenia, its therapeutic and metabolic effects associated with gene polymorphisms

Second-generation antipsychotics are widely used for the treatment of schizophrenia. Aripiprazole (ARI) is classified as a third-generation antipsychotic drug with a high affinity for dopamine and serotonin receptors. It is considered a dopamine-system stabilizer without severe side effects. In some patients the response to ARI treatment is inadequate and they require an effective augmentation strategy. It has been found that the response to the drug and the risk of adverse metabolic effects can be related to gene polymorphisms. A reduced dose is recommended for CYP2D6 poor metabolizers; moreover, it is postulated that other polymorphisms including CYP3A4, CYP3A5, ABCB1, DRD2, and 5-HTRs genes influence the therapeutic effect of ARI. ARI can increase the levels of prolactin, C-peptide, insulin, and/or cholesterol possibly due to specific genetic variants. It seems that a pharmacogenetic approach can help predict drug response and improve the clinical management of patients with schizophrenia.

Qualitative description of work of a psychotherapy group in the context of COVID pandemic

Introduction

COVID pandemic very much influenced therapeutic organisation of psychiatric care. This also applies to our hospital. Especially therapeutic activities in stationary wards.

Objectives

We would like to show changes occurring in psychotherapy group of the patients with psychotic disorder in the stationary ward in core of pandemic.

Methods

I would like to present a qualitative description of psychotherapy group in the context of COVID. The group is designed for patients with experience of psychosis, grounded in psychodynamic school and has a long tradition at an acute admission in stationary psychiatric department.

Results

During the pandemic there were epidemiological constraints. From six members of personnel in the basic assumptions, we reduced to minimum. So from two co-therapists, reflecting team and an observer, we ended leading the group every second time with one of the therapists. Despite of our efforts to maintain a continuous group, the group was closed for more than half a year and then reactivated based on old rules and roots, but less consistent memory of group members. During this most strict reduction of personnel, which would never have been accepted apart from the pandemic restrictions appeared a few interesting phenomenon. One of them was - twin groups. With the colleague we lead the group every second time. The group shows us a similar picture twice.

Conclusions

As we understand, twin groups is a way to try to keep this group together in its already damaged setting. For the moment the abstract submission group is continuing to work within its present arrangement.

Disclosure

No significant relationships.