The Journal of clinical psychiatry
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The treatment of bipolar disorder during pregnancy or in those women who wish to conceive poses a unique set of dilemmas with which clinicians should be familiar. Given the teratogenicity of some psychotropic medications used to treat bipolar disorder and incomplete reproductive safety data for agents frequently employed to manage the illness, patients and clinicians should collaborate as they weigh options regarding appropriate pharmacologic therapy during pregnancy. ⋯ However, awareness of the latest reproductive safety data across the family of compounds used to treat bipolar disorder, including antipsychotics, antidepressants, mood stabilizers, and anticonvulsants, allows for the most informed decisions. This article (1) describes the treatment dilemmas faced by bipolar women who are either pregnant or who wish to conceive, (2) reviews the teratogenic risks associated with commonly used psychotropic medications used to treat the illness, and (3) provides some clinical guidelines for treating this population during pregnancy.
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Randomized Controlled Trial Multicenter Study
Efficacy and safety of intramuscular aripiprazole in patients with acute agitation: a randomized, double-blind, placebo-controlled trial.
This multicenter, randomized, double-blind, placebo-controlled study evaluated the efficacy and safety of intramuscular (IM) aripiprazole in patients with acute agitation with a DSM-IV diagnosis of schizophrenia, schizoaffective disorder, or schizo-phreniform disorder. ⋯ ClinicalTrials.gov identifier NCT00036127.
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Randomized Controlled Trial Multicenter Study
Efficacy and safety of aripiprazole in the acute treatment of schizophrenia in Chinese patients with risperidone as an active control: a randomized trial.
Asian populations may differ from other races in response to antipsychotics. Studies of aripiprazole in Asian populations are scarce. This study aimed to investigate the efficacy, safety, and tolerability of aripiprazole in Chinese patients with acute schizophrenia or schizoaffective disorder. ⋯ ClinicalTrials.gov identifier NCT00283179.
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Antipsychotics are frequently used in the management of delirium, although there is limited information regarding the safety and efficacy of antipsychotics in treating delirium. The purpose of this study was to systematically evaluate the evidence for the efficacy and safety of antipsychotics in treating delirium. ⋯ To date, there are no published double-blind, randomized, placebo-controlled trials to establish the efficacy or safety of any antipsychotic medication in the management of delirium. There is limited evidence from uncontrolled studies that supports the use of low-dose, short-term treatment of delirium with some antipsychotics. Further study with well-designed clinical trials is required in this area.
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Increased morbidity and mortality in persons with severe mental illness (SMI) are due in large part to preventable medical conditions. An array of factors contributes to the development of obesity and other medical problems, such as diabetes and cardiovascular disease. ⋯ Nonpharmacologic interventions focusing on lifestyle changes can help to prevent and manage psychotropic-associated weight gain. Furthermore, monitoring and treatment guidelines are underutilized in people with SMI; increased use of these guidelines could help to detect and possibly prevent some cardiometabolic problems.