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Classification of antipsychotic medicines and their corresponding examples. TXNs are thioxanthenes. There is also another category known as other heterocyclic psychotropic drugs.
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Mental illnesses are a global health challenge, and effective medicines are needed to treat these conditions. Psychotropic drugs are commonly prescribed to manage mental disorders, such as schizophrenia, but unfortunately, they can cause significant and undesirable side effects, such as myocarditis, erectile dysfunction, and obesity. Furthermore, s...
Context in source publication
Context 1
... medications are classified into categories, such as sedatives, antipsychotics, hypnotics, mood stabilizers, and antidepressants. Figure 3 illustrates the classification and examples of antipsychotic drugs. The major classes of psychotropic medications that are frequently used are antidepressants and antipsychotics [42]. ...
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Introduction
The use of antipsychotics in the treatment of the mentally ill represents a complex modality, especially in specialized institutions such as the Institute of Forensic Psychiatry of Kosovo. Current best practices are summarized in clinical guidelines, which nevertheless recognize the importance of individualizing treatment. In literatur...
Citations
... 6,7 Numerous studies have revealed that altered 5-HT synthesis and metabolism, abnormalities in the levels of brain 5-HT 1A and 5-HT 2A receptors are associated with pathophysiology and efficacy in the treatment of schizophrenia. [8][9][10] The 5-HT 1A receptor encoded by HTR1A is one of the most abundant serotonin receptors in the central nervous system, and plays a crucial role in the regulation of mood, anxiety, and appetite by modulating serotonin activity. 11 Studies have shown that the HTR1A gene induces neuronal inhibition and behavioral control in the central nervous system and is involved in the molecular mechanisms of schizophrenia. ...
Purpose
We investigate the association of HTR1A rs10042486 and rs6295 with efficacy and plasma concentrations of atypical antipsychotics in the treatment of male patients with schizophrenia.
Patients and Methods
A total of 140 male patients diagnosed with schizophrenia who were treated with any single atypical antipsychotic between May 2020 and May 2022 were retrospectively included. Clinical symptoms were assessed using Positive and Negative Syndrome Scale (PANSS). All SNPs were typed using Agena Bioscience MassARRAY DNA mass spectrometry. Plasma concentrations of antipsychotics at week 3, 6 and 12 after treatment commence were analyzed using mass spectrometry.
Results
For efficacy of atypical antipsychotics, we observed no significant difference between HTR1A rs10042486, rs6295 and positive symptom improvement, where the patients with heterozygous mutant at the rs10042486 and rs6295 locus were superior to those with wild-type or homozygous mutant genotypes on negative symptom improvement, especially at 12 weeks of follow-up when the difference between genotypes at the rs6295 locus have statistical significance (P = 0.037). For plasma concentration, we found that quetiapine plasma concentrations were significantly lower in patients with mutation-heterozygous types than in wild-type and homozygous mutation genotypes at week 6. In contrast, higher plasma concentrations were found for mutant heterozygous than wild genotypes in the risperidone monotherapy analysis, and the difference among genotypes at the rs6295 locus was statistically significant at 6 weeks of follow-up.
Conclusion
The assessment of the correlation of genetic polymorphisms of HTR1A rs6295 and rs10042486 in male patients with schizophrenia with the monitoring of therapeutic drug concentrations and therapeutic efficacy provides a constructive foundation for the clinical individualization of antipsychotics, such as quetiapine and risperidone, which is important in selecting the dose of the medication and improving the improvement of negative symptoms.
... Not only does it enhance the serotoninergic transmission, but serotonin, a key neurotransmitter of the brain-gut axis, also plays a vital role in the pathogenesis of emotional distress and gastrointestinal diseases [13]. Specifically, it binds serotonin (5-hydroxytryptamine; 5HT) 5HT2A, adrenergic (α1), muscarinic, and histaminergic receptors, and it has a relatively weak affinity for dopamine D2 receptors [14,15], with an occupancy half-life about twice as long as that for plasma. All of these are cell-surface receptors that intervene in cellular communication. ...
Quetiapine is a second-generation antipsychotic drug available for two and half decades. Due to increased misuse, prescription outside the approved indications, and availability on the black market, it is being encountered in medicolegal autopsies more frequently. For instance, it has been linked to increased mortality rates, most likely due to its adverse effects on the cardiovascular system. Its pharmacokinetic features and significant postmortem redistribution challenge traditional sampling in forensic toxicology. Therefore, a systematic literature review was performed, inclusive of PubMed, the Web of Science—core collection, and the Scopus databases; articles were screened for the terms “quetiapine”, “death”, and “autopsy” to reevaluate each matrix used as a surrogate endpoint in the forensic toxicology of quetiapine-related deaths. Ultimately, this review considers the results of five studies that were well presented (more than two matrices, data available for all analyses, for instance). The highest quetiapine concentrations were usually measured in the liver tissue. As interpreted by their authors, the results of the considered studies showed a strong correlation between some matrices, but, unfortunately, the studies presented models with poor goodness of fit. The distribution of quetiapine in distinct body compartments/tissues showed no statistically significant relationship with the length of the postmortem interval. Furthermore, this study did not confirm the anecdotal correlation of peripheral blood concentrations with skeletal muscle concentrations. Otherwise, there was no consistency regarding selecting an endpoint for analysis.
... In addition, the use of epidural analgesia and sedation with propofol has been shown to have some correlation, but the available information is not yet definitive [19] . Anticholinergic drugs may cause delirium, and there is strong evidence linking systemic corticosteroids to the development of delirium in individuals who were previously neither delirious or comatose [20] . The relationship between delirium and psychopharmacological agents is probably caused by their impact on neurotransmitters that seem to play a crucial role in the development of delirium, including acetylcholine, gamma-amino butyric acid (GABA), dopamine, and serotonin. ...
