The Journal of clinical psychiatry
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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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A critical step in addressing excess medical morbidity and mortality in persons with serious mental illness is to better understand and seek to improve the medical care that they receive. Medical quality deficits for persons with serious mental illness include problems related to overuse of certain medical services, such as emergency room care; underuse of some evidence-based general medical services; and misuse, or medical error. ⋯ Research studies and demonstration programs for improving medical care in this population have spanned a continuum of medical provider involvement from psychiatrist and patient training to on-site consultation by medical staff, multidisciplinary collaborative care approaches, and facilitated linkages between community and mental health and medical providers. Ultimately, it will be important to develop, test, and implement a range of models for improving the medical care of persons with serious mental disorders that are tailored to patients' needs, mental health system capacities, and local community resources.
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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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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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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.