Atypical antipsychotics: recent research findings and applications to clinical practice: Proceedings of a symposium presented at the 29th Annual European College of Neuropsychopharmacology Congress, 19 September 2016, Vienna, Austria.

MURRAY, Robin, CORRELL, Christoph U, REYNOLDS, Gavin and TAYLOR, David (2017). Atypical antipsychotics: recent research findings and applications to clinical practice: Proceedings of a symposium presented at the 29th Annual European College of Neuropsychopharmacology Congress, 19 September 2016, Vienna, Austria. Therapeutic advances in psychopharmacology, 7 (1 Supp), 1-14. (In Press)

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Link to published version:: 10.1177/2045125317693200

Abstract

Available evidence suggests that second-generation atypical antipsychotics are broadly similar to first-generation agents in terms of their efficacy, but may have a more favourable tolerability profile, primarily by being less likely to cause extrapyramidal symptoms. However, atypical antipsychotics are variably associated with disturbances in the cardiometabolic arena, including increased body weight and the development of metabolic syndrome, which may reflect differences in their receptor binding profiles. Effective management of schizophrenia must ensure that the physical health of patients is addressed together with their mental health. This should therefore involve consideration of the specific tolerability profiles of available agents and individualization of treatment to minimize the likelihood of adverse metabolic sequelae, thereby improving long-term adherence and optimizing overall treatment outcomes. Alongside this, modifiable risk factors (such as exercise, diet, obesity/body weight and smoking status) must be addressed, in order to optimize patients' overall health and quality of life (QoL). In addition to antipsychotic-induced side effects, the clinical management of early nonresponders and psychopharmacological approaches for patients with treatment-resistant schizophrenia remain important unmet needs. Evidence suggests that antipsychotic response starts early in the course of treatment and that early nonresponse accurately predicts nonresponse over the longer term. Early nonresponse therefore represents an important modifiable risk factor for poor efficacy and effectiveness outcomes, since switching or augmenting antipsychotic treatment in patients showing early nonresponse has been shown to improve the likelihood of subsequent treatment outcomes. Recent evidence has also demonstrated that patients showing early nonresponse to treatment with lurasidone at 2 weeks may benefit from an increase in dose at this timepoint without compromising tolerability/safety. However, further research is required to determine whether these findings are generalizable to other antipsychotic agents.

Item Type: Article
Additional Information: ** From PubMed via Jisc Publications Router. ** History: ** received: 20-12-2016 ** accepted: 17-01-2017
Uncontrolled Keywords: antipsychotic, cardiometabolic side effects, efficacy, nonresponse, schizophrenia, tolerability, treatment resistance
Research Institute, Centre or Group: Biomolecular Sciences Research Centre
Identification Number: 10.1177/2045125317693200
SWORD Depositor: Helen Garner
Depositing User: Helen Garner
Date Deposited: 17 May 2017 15:18
Last Modified: 17 May 2017 15:18
URI: http://shura.shu.ac.uk/id/eprint/15511

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