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Del Casale A, Sorice S, Padovano A, Simmaco M, Ferracuti S, Lamis DA, Rapinesi C, Sani G, Girardi P, Kotzalidis GD, Pompili M. Psychopharmacological Treatment of Obsessive-Compulsive Disorder (OCD). Curr Neuropharmacol 2020; 17:710-736. [PMID: 30101713 PMCID: PMC7059159 DOI: 10.2174/1570159x16666180813155017] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/06/2018] [Accepted: 08/12/2018] [Indexed: 02/07/2023] Open
Abstract
Background: Obsessive-compulsive disorder (OCD) is associated with affective and cognitive symptoms causing personal distress and reduced global functioning. These have considerable societal costs due to healthcare service utilization. Objective: Our aim was to assess the efficacy of pharmacological interventions in OCD and clinical guidelines, providing a comprehensive overview of this field. Methods: We searched the PubMed database for papers dealing with drug treatment of OCD, with a specific focus on clinical guidelines, treatments with antidepressants, antipsychotics, mood stabilizers, off-label medications, and pharmacogenomics. Results: Prolonged administration of selective serotonin reuptake inhibitors (SSRIs) is most effective. Better results can be obtained with a SSRI combined with cognitive behavioral therapy (CBT) or the similarly oriented exposure and response prevention (ERP). Refractory OCD could be treated with different strategies, including a switch to another SSRI or clomipramine, or augmentation with an atypical antipsychotic. The addition of medications other than antipsychotics or intravenous antidepressant administration needs further investigation, as the evidence is inconsistent. Pharmacogenomics and personalization of therapy could reduce treatment resistance. Conclusions: SSRI/clomipramine in combination with CBT/ERP is associated with the optimal response compared to each treatment alone or to other treatments. New strategies for refractory OCD are needed. The role of pharmacogenomics could become preponderant in the coming years.
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Affiliation(s)
- Antonio Del Casale
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Serena Sorice
- Residency School in Psychiatry, Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Alessio Padovano
- Residency School in Psychiatry, Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Maurizio Simmaco
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | | | - Dorian A Lamis
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Chiara Rapinesi
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Gabriele Sani
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Paolo Girardi
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Georgios D Kotzalidis
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Maurizio Pompili
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
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Girardi P, Del Casale A, Rapinesi C, Kotzalidis GD, Splendori F, Verzura C, Trovini G, Sorice S, Carrus D, Mancinelli I, Comparelli A, De Filippis S, Francomano A, Ballerini A, Marcellusi A, Mennini FS, Ducci G, Sani G, Pompili M, Brugnoli R. Predictive factors of overall functioning improvement in patients with chronic schizophrenia and schizoaffective disorder treated with paliperidone palmitate and aripiprazole monohydrate. Hum Psychopharmacol 2018; 33:e2658. [PMID: 29766576 DOI: 10.1002/hup.2658] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/22/2018] [Accepted: 04/09/2018] [Indexed: 11/11/2022]
Abstract
BACKGROUND Long-acting injectable (LAI) antipsychotics can improve medication adherence and reduce hospitalisation rates compared with oral treatments. Paliperidone palmitate (PAL) and aripiprazole monohydrate (ARI) LAI treatments were associated with improvements in global functioning in patients with schizophrenia. OBJECTIVE The objective of this study was to assess the predictive factors of better overall functioning in patients with chronic schizophrenia and schizoaffective disorder treated with PAL and ARI. METHOD Enrolled were 143 (97 males, 46 females, mean age 38.24 years, SD = 12.65) patients with a diagnosis of schizophrenia or schizoaffective disorder, whom we allocated in two groups (PAL and ARI treatments). We assessed global functioning, amount of oral medications, adherence to oral treatment, and number of hospitalisations before LAI introduction and at assessment time point. RESULTS Longer treatment time with LAIs (p < .001), lower number of oral drugs (p < .001), and hospitalisations (p = .002) before LAI introduction, and shorter duration of illness (p = .038) predicted better Global Assessment of Functioning scores in the whole sample (R2 = 0.337). CONCLUSION Early administration and longer duration of ARI or PAL treatments could play a significant role in improving global functioning of patients with schizophrenia and schizoaffective disorder. Better improvement in functioning could be achieved with ARI in young individuals with recent illness onset and PAL in patients at risk for recurrent hospitalisations.
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Affiliation(s)
- Paolo Girardi
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
| | - Antonio Del Casale
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
| | - Chiara Rapinesi
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
| | - Georgios D Kotzalidis
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
| | - Francesca Splendori
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
| | - Claudio Verzura
- Residency School in Psychiatry, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Giada Trovini
- Residency School in Psychiatry, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Serena Sorice
- Residency School in Psychiatry, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Dario Carrus
- Mental Health Department, Azienda Sanitaria Locale Viterbo, Viterbo, Italy
| | - Iginia Mancinelli
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
| | - Anna Comparelli
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
| | | | - Antonio Francomano
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy
| | - Andrea Ballerini
- Department of Neuroscience, Psychology, Drug Research and Child Health, Section of Neuroscience, University of Florence, Florence, Italy
| | - Andrea Marcellusi
- Faculty of Economics, Centre for Economic and International Studies (CEIS)-Economic Evaluation and HTA (EEHTA), Tor Vergata University, Rome, Italy
| | - Francesco S Mennini
- Faculty of Economics, Centre for Economic and International Studies (CEIS)-Economic Evaluation and HTA (EEHTA), Tor Vergata University, Rome, Italy
| | - Giuseppe Ducci
- Mental Health Department, Azienda Sanitaria Locale Roma 1, Rome, Italy
| | - Gabriele Sani
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
| | - Maurizio Pompili
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
| | - Roberto Brugnoli
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
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Pompili M, Verzura C, Trovini G, Buscajoni A, Falcone G, Naim S, Nardella A, Sorice S, Baldessarini RJ, Girardi P. Lurasidone: efficacy and safety in the treatment of psychotic and mood disorders. Expert Opin Drug Saf 2017; 17:197-205. [PMID: 28902525 DOI: 10.1080/14740338.2017.1379989] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Lurasidone ([3aR,4S,7R,7aS]-2-[(1R,2R)-2-[4-(1,2-benzisothiazol-3-yl)piperazin-1yl-methyl] cyclohexylmethyl]-hexahydro-4,7-methano-2H-isoindole-1,3-dione hydrochloride; Latuda®) is a novel benzisothiazole, second-generation antipsychotic drug developed by Dainippon Sumitomo Pharma Corporation in Japan. Similar to other atypical antipsychotics it has a distinctive pharmacodynamic profile, Areas covered: This review updates reported research findings on the efficacy, safety and tolerability of LRSD for treatment of psychotic and major affective disorders, with meta-analyses. Short-term efficacy of LRSD in schizophrenia is supported by several randomized, controlled trials with daily doses of 40-160 mg, yielding relatively modest symptomatic improvements. Lurasidone has regulatory approval for treatment of undefined duration in schizophrenia. Long-term benefits and effects in schizophrenia, and both short- and long-term use for other psychotic disorders and mania have not been tested. LRSD shows unusual efficacy in acute bipolar depression even without psychotic features. However, trials of adding LRSD to lithium or valproate for bipolar disorder have yielded inconsistent findings. Expert opinion: Available research findings indicate that LRSD is effective and well-tolerated for short-term treatment of schizophrenia, and for acute bipolar depression. It has low risk of inducing weight-gain, metabolic, or cardiac abnormalities, but its risk of akathisia may exceed that of other modern antipsychotics. Needed is adequate long-term testing in schizophrenia and bipolar disorder and testing for other indications, including against alternative treatments.
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Affiliation(s)
- Maurizio Pompili
- a Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center , Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy
| | - Claudio Verzura
- b Psychiatry Residency Training Program, Faculty of Medicine and Psychology , Sapienza University of Rome , Rome , Italy
| | - Giada Trovini
- b Psychiatry Residency Training Program, Faculty of Medicine and Psychology , Sapienza University of Rome , Rome , Italy
| | - Andrea Buscajoni
- b Psychiatry Residency Training Program, Faculty of Medicine and Psychology , Sapienza University of Rome , Rome , Italy
| | - Giulia Falcone
- b Psychiatry Residency Training Program, Faculty of Medicine and Psychology , Sapienza University of Rome , Rome , Italy
| | - Stefano Naim
- b Psychiatry Residency Training Program, Faculty of Medicine and Psychology , Sapienza University of Rome , Rome , Italy
| | - Adele Nardella
- b Psychiatry Residency Training Program, Faculty of Medicine and Psychology , Sapienza University of Rome , Rome , Italy
| | - Serena Sorice
- b Psychiatry Residency Training Program, Faculty of Medicine and Psychology , Sapienza University of Rome , Rome , Italy
| | - Ross J Baldessarini
- c Department of Psychiatry, Harvard Medical School; International Consortium for Bipolar and Psychotic Disorders Research, Mailman Research Center , McLean Hospital , Boston , MA , USA
| | - Paolo Girardi
- a Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center , Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy
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Del Casale A, Rapinesi C, Kotzalidis GD, Sorice S, Padovano A, Gentile G, Angeletti G, Ferracuti S, Sani G, Pompili M, Simmaco M, Girardi P. Stable Remission of Multiple Chemical Sensitivity Syndrome and Major Depression With Citalopram and 1-Month Deep Transcranial Magnetic Stimulation: A Case Report. J ECT 2017; 33:e27-e29. [PMID: 28570499 DOI: 10.1097/yct.0000000000000420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Antonio Del Casale
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), School of Medicine and Psychology, Sapienza University and Unit of Psychiatry, Sant'Andrea Hospital, Rome and Department of Psychiatric Rehabilitation, P. Alberto Mileno Onlus Foundation, San Francesco Institute, Vasto, Chieti, Italy, Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), School of Medicine and Psychology, Sapienza University, Rome, Italy. Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), School of Medicine and Psychology, Sapienza University and Unit of Psychiatry, Sant'Andrea Hospital, Rome, Italy Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), School of Medicine and Psychology, Sapienza University and Advanced Molecular Diagnostics Unit (DiMA), Sant'Andrea Hospital, Rome, Italy Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), School of Medicine and Psychology, Sapienza University and Unit of Psychiatry, Sant'Andrea Hospital, Rome, Italy Department of Neurology and Psychiatry, Sapienza University, Rome, Italy Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), School of Medicine and Psychology, Sapienza University and Unit of Psychiatry, Sant'Andrea Hospital, Rome, Italy Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), School of Medicine and Psychology, Sapienza University and Advanced Molecular Diagnostics Unit (DiMA), Sant'Andrea Hospital, Rome, Italy Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), School of Medicine and Psychology, Sapienza University and Unit of Psychiatry, Sant'Andrea Hospital, Rome, Italy
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Del Casale A, Kotzalidis GD, Rapinesi C, Sorice S, Girardi N, Ferracuti S, Girardi P. Functional Magnetic Resonance Imaging Correlates of First-Episode Psychoses during Attentional and Memory Task Performance. Neuropsychobiology 2017; 74:22-31. [PMID: 27698323 DOI: 10.1159/000448620] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 07/21/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND The nature of the alteration of the response to cognitive tasks in first-episode psychosis (FEP) still awaits clarification. We used activation likelihood estimation, an increasingly used method in evaluating normal and pathological brain function, to identify activation changes in functional magnetic resonance imaging (fMRI) studies of FEP during attentional and memory tasks. METHODS We included 11 peer-reviewed fMRI studies assessing FEP patients versus healthy controls (HCs) during performance of attentional and memory tasks. RESULTS Our database comprised 290 patients with FEP, matched with 316 HCs. Between-group analyses showed that HCs, compared to FEP patients, exhibited hyperactivation of the right middle frontal gyrus (Brodmann area, BA, 9), right inferior parietal lobule (BA 40), and right insula (BA 13) during attentional task performances and hyperactivation of the left insula (BA 13) during memory task performances. CONCLUSIONS Right frontal, parietal, and insular dysfunction during attentional task performance and left insular dysfunction during memory task performance are significant neural functional FEP correlates.
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Affiliation(s)
- Antonio Del Casale
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), School of Medicine and Psychology, Sapienza University, Rome, Italy
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Prisco V, Sorice S, Franza F, Fabrazzo M. Effect of metformin treatment on metabolic parameters in atypical antipsychotic-treated schizophrenic patients. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.2028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Few studies have compared the effect of Metformin treatment on metabolic parameters in atypical antipsychotic-treated schizophrenic patients. The present study examined metabolic abnormalities due to clozapine or olanzapine in schizophrenic patients and, secondly, the effect of metformin treatment on these parameters. Twenty-six patients (19 M and 7 F) from neuropsychiatric nursing home “Villa dei pini” (Avellino) were enrolled, in collaboration with our Department of Psychiatry, University of Naples SUN. All patients had been diagnosed according to DSM-IV criteria. They were recruited from July 2013 to January 2015. Clozapine or olanzapine-related hyperglycemia required metformin introduction in therapy. All prescribed drugs were maintained at the same therapeutic daily dose during our study. We performed 1, 3 and 6 months follow up after metformin initiation. For each patient fasting cholesterol, glucose, triglycerides, body weight (BW), body mass index (BMI), systolic and diastolic blood pressure (BP) were evaluated. SPSS 16.0 (Statistical Package for Social Science) was used for data analysis. After antipsychotic treatment BMI, fasting glucose and triglycerides were significantly higher respect to basal values (P < 0.01, P < 0.0001, P < 0.05, respectively). After metformin treatment, a significant improvement in fasting glucose, cholesterol and triglycerides was registered (P < 0.001). Conversely, BMI values, although not significant (P < 0.168), showed a trend in increasing. This observational study underlines that metformin in antipsychotic-treated patients could be useful in preventing clozapine or olanzapine related metabolic abnormalities in schizophrenic patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Sorice S, Hokugo A, Buck A, Meliton V, Zuk P, Huang W, Miller T, Parhami F, Jarrahy R. Additive Effect of BMP-2 and Oxysterol in Inducing Osteogenic Differentiation in Rabbit Bone Marrow Stromal Cells. J Surg Res 2012. [DOI: 10.1016/j.jss.2011.11.930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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de Jong MD, Vella S, Carr A, Boucher CA, Imrie A, French M, Hoy J, Sorice S, Pauluzzi S, Chiodo F, Weverling GJ, van der Ende ME, Frissen PJ, Weigel HM, Kauffmann RH, Lange JM, Yoon R, Moroni M, Hoenderdos E, Leitz G, Cooper DA, Hall D, Reiss P. High-dose nevirapine in previously untreated human immunodeficiency virus type 1-infected persons does not result in sustained suppression of viral replication. J Infect Dis 1997; 175:966-70. [PMID: 9086161 DOI: 10.1086/514002] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
High-dose nevirapine treatment has been reported to confer sustained antiretroviral effects, despite a rapid development of resistance. The use of this strategy was evaluated in 20 previously untreated human immunodeficiency virus type 1 (HIV-1) p24 antigenemic persons with CD4 cell counts between 100 and 500/mm3. Treatment consisted of 400 mg of nevirapine, after a 2-week lead-in dose of 200 mg. Rash was the most frequently reported adverse event, occurring in 25%. While sustained declines in p24 antigen levels were observed in the majority, serum HIV-1 RNA load and CD4 cell counts returned to baseline values within 12 weeks in virtually all subjects. The resistance-conferring tyrosine-to-cysteine substitution at reverse transcriptase position 181 was detected after 4 weeks in most subjects. These observations suggest that plasma drug levels attained with high-dose nevirapine were not sufficient to inhibit nevirapine-resistant virus, although they were approximately 2-fold higher than reported IC50 values of resistant virus.
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Affiliation(s)
- M D de Jong
- National AIDS Therapy Evaluation Centre, Department of Infectious Diseases, University of Amsterdam, Netherlands
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