Group Membership Logo
Search
View Cart (0)

This Month in Psychopharmacology

Get Email Alerts

Categories

Categories

2018 NEI Congress Young Investigator Poster Competition Winners

November 10, 2018

 
The Need for Speed: Adjunctive Triple Chronotherapy. An Accelerated Intervention in the Treatment of Acute Depression in the Adolescent Population
Diane Hurd, PMHNP; Mariela Herrera, MD; Nicholas Coombs, MS; Jeannine M. Brant, PhD, APRN, AOCN, FAAN; Eric Arzubi, MD
Collaborative Science and Innovation Department, Billings Clinic, Billings, MT
 
1ST PLACE Objective: This pilot study aims to explore the feasibility and proof of concept of triple chronotherapy (TCT) as a non-pharmacological, adjunctive intervention in the treatment of acute depression in the adolescent population.

Method: Thirty-one adolescents with moderate to severe depression were included in the study. Each participant underwent a  4-day intervention (TCT) which consisted of one night of sleep deprivation followed by three days of sleep phase advancement and daily bright light therapy. Primary outcomes were feasibility and depression, as measured by the Hamilton Depression Scale-17 (HAMD-17). Secondary outcomes included severity of illness, anxiety, self-harm, insomnia, and suicidality.

Results: Twenty-nine (94%) adolescents completed the TCT protocol. Twenty-six (84%) of the 31 enrolled patients experienced a reduction in depressive symptoms of at least 50% from baseline; 24 (77%) achieved remission, defined as a HAMD-17 score less than 8. The mean depression score was severe prior to the start of the intervention (¯=21.8 ± 3.8) and dropped below the remission threshold by day 4 (¯=4.4 ± 5.1; p<.001); the mean depression score was mild at 1-week (n=17; =9.3 ± 5.2; p<.001) and 1-month (n=10, ¯=7.8 ± 5.2; p<.001). Severity of illness scores according to the Clinical Global Impression improved from a mean of 5.3 at baseline to 3.1 following the TCT intervention (p<.0001); the effect was sustained through the 1-week post-discharge and the 1-month follow-ups. Secondary outcomes showed significant improvement following the 4-day TCT intervention; improvement was sustained through the 1-week and 1-month follow-up periods.

Conclusion: This pilot study determined TCT to be a feasible, safe, accelerated, and promising adjunctive treatment for acute depression in the adolescent population.
 
 
Practical Outpatient Pharmacotherapy for Alcohol Use Disorder
Youngjung Kim, MD, PhD1; Laura Hack, MD, PhD2; Elizabeth Ahn, MD3; Jungjin Kim, MD2,4
1Department of Psychiatry, Kahn School of Medicine at Mount Sinai, New York, NY; 2Department of Psychiatry, Emory University School of Medicine, Atlanta, GA; 3Department of Psychiatry, University of Florida School of Mddicine, Gainesville, FL; 4Division of Alcohol and Drug Abuse, McLean Hospital and Massachusetts General Hospital Boston, MA
 
2ND PLACE Alcohol use disorder (AUD) is commonly encountered in clinical practice. A combination of psychosocial intervention and pharmacotherapy is the cornerstone of AUD treatment. Despite their efficacy, safety, and cost-effectiveness, clinicians are relucatant to prescribe medications to treat individuals with AUD. Given the high rate of relapse with psychosocial intervention alone, increasing patient access to this underutilized treatment has the potential to improve clinical outcome in this difficult-to-treat population.

This study aims to review the evidence for efficacy and side effects of both on- and off-label agents with a focus on clinical applicability, and to provide strategic guidelines to optimize treatment outcomes that are grounded in empiricaL evidence and incoprorate consideration of comorbidities and side-effect profiles.

Recommendations are supported by findings from randomized controlled trials (RCT) and meta-analyses selected to be representative, where possible, of current treatment guidelines. The goal of this paper is to help readers use pharmacotherapy with greater confidence when treating patients with AUD.
 
 
Differential Aspects Between Schizophrenia Treatment Approaches: Oral Antipsychotics vs. Aripiprazole Long-Acting Injectable
S Arques Egea1; E Ros Cucurull2; C Iranzo Tatay1; C Parro-Torres3; RF Palma-Álvarez2; E Castrillo4; MA Cantillo4; P Aznar5
1Psychiatrist, La Fe University Hospital (Valencia); 2Psychiatrist, Vall Hebrón University Hospital (Barcelona); 3Psychiatrist, Gregorio Marañón University Hospital (Madrid); 4Nurse, Vall Hebrón University Hospital (Barcelona); 5Nurse, La Fe University Hospital (Valencia)
 
3RD PLACE Aim: The objective of the study is to evaluate the differences in health outcomes as well as treatment satisfaction and functionality, focusing particularly in cognitive deficits and perceived disability among stable psychotic patients with therapeutic adherence treated with oral antipsychotics (OA) vs Aripiprazole Long Acting Injectable (A-LAI).

Method: Naturalistic study, descriptive and transversal. Inclusion criteria: Schizophrenia; 18-65 years old; CGI≤3; treatment OA or A-LAI; no changes antipsychotic therapy in last 3 months. Sociodemographic and clinical variables were recorded using self-applied scales (TSQM;EQ-5;SDI;PDQ) and heteroaplied (PSP;CGI;UKU). A mirror analysis was performed in the A-LAI group comparing number of psychiatric drugs and antipsychotic used, previous admissions and emergency care visits.

Results: 50 patients (25 OA, 25 A-LAI), 62% male, age 43,9±11,1, psyc hotic illness evolution 15,9±9,9. In comparison with OA, A-LAI patients present greater functionality scores (PSP) 75±11,5 vs 61,8,±10,5 (p.001) and better results in quality of life (EQ-5D), both quantitatively, 69±18,6 vs 48,3±22,1 (p.005), and qualitatively (particularly in everyday tasks, OR 0,15 (p.009), and better health during the last year OR 0,16 (p.011). Additionally A-LAI patients showed less disability compared to OA, particularly in work areas (4,7 vs 6,8,p.017), social life (4,5 vs 6,6,p.006), overall disability (13 vs 18,p.022) and perceived stress (4,2 vs 6,2,p.020). Perceived cognitive deficits were lower in the A-LAI group, particularly in attention and concentration. There were significant differences in weight gained OR 0,22 (p.082) and sexual disfunction OR 0,078 (p.000) in favor of A-LAI. Prolactin levels are higher for the OA group, 41,7±30,8 vs 8,6±11,67ng/ml (p.003). Treatment satisfaction (TSQM) was significantly higher in A-LAI patients in all 4 dimensions. The factor that most influences the improvement in the functionality is the treatment with A-LAI instead of OA (-10,9±4,1,p.0117). ALAI patients required a lower number of psychiatric drugs than OA. In A-LAI patients group was observed a statistical significant difference in the number of hospitalizations (1,8 vs 0,08,p.002), the number of admission days to the hospital (45,4 vs 1,5,p.010) and the number of emergency care needed (3,96 vs 0,6,p.000); furthermore, the number of antipsychotics was significantly reduced (2±1,3 vs 0,2±0,4) as well as the number of overall psychotic drugs (4,5±2,1 vs 2,2±1,4).

Conclusion: According to the data from our study patients with schizophrenia that are treated with A-LAI show better results in quality of life, functionality, less perceived disability and cognitive deficits compare to those that received OA, as well as more levels of treatment satisfaction. Tolerance of A-LAI has been better than OA, particularly in the sexual and weight areas, being prolactin levels also lower. The change to A-LAI has allowed a reduced use of health resources.
 
Share, disseminate, and promote your accomplishments and contributions to the field at the 2019 NEI Congress Scientific Poster Session and Reception!
Submission deadline: August 15, 2019
Poster session: November 8, 2019