Efficacy, tolerability, and safety of xanomeline-trospium chloride for schizophrenia: A systematic review and meta-analysis

European Neuropsychopharmacology, Journal Year: 2024, Volume and Issue: 92, P. 62 - 73

Published: Dec. 25, 2024

The United States Food and Drug Administration approved xanomeline-trospium combination for schizophrenia on September-26-2024. We conducted a PRISMA 2020-compliant systematic review with random-effects meta-analysis the efficacy safety of in randomized controlled trials patients (MEDLINE, EMBASE, Cochrane, PsycINFO, October-01-2024). Co-primary outcomes were Positive And Negative Syndrome Scale (PANSS) total score (standardized mean difference=SMD), all-cause discontinuation (risk ratio=RR). Cochrane's Risk Bias (RoB) Tool 2 GRADE used. Xanomeline-trospium (k = 3, acute exacerbation, RoB=low, baseline N 690, males=75.5 %, age=44.3 + 11.0, duration=5 weeks) outperformed placebo PANSS (SMD=-0.56, 95 % confidence interval/CI=-0.72/-0.40), positive (SMD=-0.59, %CI=-0.75/-0.43), negative (SMD=-0.33, %CI=-0.49/-0.17), Marder Factor symptom (SMD=-0.36, %CI=-0.60/-0.13), Clinical Global Impression-Severity (SMD=-0.54, %CI=-0.71/-0.37) (GRADE=moderate), response (≥30 reduction from baseline: RR=2.13, %CI=1.66-2.75). ≥7 weight gain (RR=0.46, %CI=0.25-0.87, NNT=19), low-density lipoprotein-cholesterol high-density levels reduced, while risk was increased vomiting, hypertension, nausea, dry mouth, dyspepsia, constipation (RR=7.60, %CI=1.50-38.57 to RR=2.72, %CI=1.63-4.55), any adverse event (RR=1.33, %CI=1.18-1.51, NNT=6), triglyceride supine heart rate (GRADE=moderate high). Conversely, not other, serious, or severe events discontinuation. In post-hoc analyses, regarding (≥20 ≥30 threshold) starting at week 2, symptoms prominent symptoms, cognitive ≥1 standard deviation below general population norm. Further, pro-/anti-cholinergic side effects mild-moderate mostly transient. is an effective treatment unique tolerability profile, potentially addressing unmet needs.

Language: Английский

---

Effects of antidepressants on body weight in patients treated in a naturalistic setting in Oman

Middle East Current Psychiatry, Journal Year: 2025, Volume and Issue: 32(1)

Published: Jan. 14, 2025

Abstract Background The rising use of antidepressants is critical for managing mental health disorders, but weight gain a concerning side effect, particularly with certain classes like TCAs and SSRIs. This study aims to investigate changes in Omani patients prescribed paroxetine, fluoxetine, mirtazapine, or venlafaxine. Method A cross-sectional conducted from January June 2023 at Sultan Qaboos University Hospital recruited adults disorders on these medications. Weight measurements were taken baseline follow-up, clinically significant defined as ≥ 7% increase. Results total 135 participants analyzed, showing mean 5.54 kg, 60.7% experiencing gain. Mirtazapine paroxetine exhibited the highest average increases (7.51 kg 8.05 respectively) compared fluoxetine (0.69 kg) venlafaxine (4.32 kg). No demographic factors influenced ( p = 0.213). Conclusion highlights among antidepressants, mirtazapine paroxetine. underscores importance monitoring clinical practice necessitates further investigations into individualized treatment strategies manage both weight-related concerns.

Language: Английский

---

Treatments for weight gain in schizophrenia

Current Opinion in Psychiatry, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 13, 2025

Purpose of review Obesity and related metabolic disorders are extremely common in psychiatric patients, particularly those with schizophrenia. Elucidating this link's neurobiology may inform clinicians researchers rational therapeutic approaches necessary to optimize clinical outcomes. Recent findings Current literature highlights the pivotal role inflammation-oxidative stress-insulin resistance loop pathophysiology both neuropsychiatric disorders. The concept ‘diabetophrenia’ is put forward highlight overlapping neurobiological mechanisms underlying dysfunction schizophrenia symptoms. Innovative treatments, including combination xanomeline trospium incretin-based medicines, demonstrate encouraging potential addressing such complex health challenges. Summary nuanced dynamics chronic inflammation symptomatology underscore significance mental factors a cohesive fashion while considering unique psychosocial contexts, dietary preferences, lifestyle choices. A multidisciplinary strategy essential for incorporating counseling, interventions, behavioral therapies, pharmacotherapy into management ensuing enhanced collaboration among healthcare professionals render obsolete prevailing siloed conceptualizations disorders, opening new vistas generating synergistic insights mind-body systems leading improved quality life patients other conditions.

Language: Английский

---

Connecting the dots: Understanding and addressing the metabolic impact of antipsychotic and antidepressant medications

Annals of the New York Academy of Sciences, Journal Year: 2025, Volume and Issue: unknown

Published: March 12, 2025

Abstract Serious mental disorders such as schizophrenia and major depression are associated with considerable morbidity mortality, resulting in much shorter life expectancies those affected. The discovery of antipsychotic medications ushered improved health outcomes for people serious but also brought about increased due to their metabolic side effects, including obesity diabetes mellitus. Antidepressant have a more favorable effect profile, some can still cause weight gain hyperglycemia. In this narrative review, we discuss antidepressant medications’ mechanisms action, respective effectiveness treating psychosis depression, effects. addition, present therapeutic strategies minimizing cardiometabolic risks patients treated these by applying comprehensive, biopsychosocial approach.

Language: Английский

---

Obesity and psychology: a bibliometric analysis of half a century

Frontiers in Nutrition, Journal Year: 2025, Volume and Issue: 12

Published: April 16, 2025

The interaction mechanisms between obesity and psychological factors are intricate bidirectional. Psychological issues can prompt unhealthy eating behaviors, impede weight management efforts, elevate the risk of obesity. This study employs bibliometric approaches to conduct a comprehensive analysis knowledge structure, research hotspots, development trends in field psychology, offering valuable references for future this area. draws on Web Science Core Collection (WoSCC) database, with "obesity" "psychology" serving as primary search terms. Leveraging CiteSpace (version 6.3.R1) VOSviewer 1.6.20) software, analyses were conducted various indicators, including number publications, publication volume, authors, journals, references, countries, institutions, keywords. Through co-citation keyword co-occurrence analysis, hotspots developmental trajectories revealed. Based inclusion exclusion criteria, total 2,753 relevant articles ultimately included study. results indicate that since 21st century, there has been significant surge publications psychology. Developed countries like United States, Canada, Kingdom, Australia at forefront field. Leading institutions include Yale University, University College London, Pennsylvania. Among GRILO CM highest output. Research hotspot keywords primarily "depression," "stress," "emotional eating," "bariatric surgery," "intervention," "weight stigma," "self-regulation." Current reveal marked regional imbalance international collaboration In particular, exists notable absence substantive cooperation developed developing countries. mainly center around following aspects: Firstly, it focuses prevalence common distress symptoms, depression, anxiety, stress, within obese population implications these symptoms have health. Secondly, mental health binge emotional play pivotal role onset maintenance Thirdly, psychosocial health-related quality life stigma core intervention potential impacts behavioral change. Meanwhile, researchers increasingly concentrating individualized requirements populations, emphasizing importance evidence-based interventions These not only enhance our understanding complex relationship but also provide crucial theoretical foundations practical insights directions. in-depth developments reveals current status characteristics from multiple perspectives, scientific backing identify collaborators, pinpoint issues, keep abreast latest developments. Looking forward future, related further expand data sources, diversify viewpoints, delve more profoundly into

Language: Английский

---

The efficacy, mechanisms and implementation of physical activity as an adjunctive treatment in mental disorders: a meta‐review of outcomes, neurobiology and key determinants

World Psychiatry, Journal Year: 2025, Volume and Issue: 24(2), P. 227 - 239

Published: May 15, 2025

Research examining physical activity interventions for mental disorders has grown exponentially in the past decade. At this critical juncture, there is a need to synthesize best evidence guide researchers, clinicians and people with lived experience. This meta‐review aimed systematically identify comprehensively evaluate current about: a) efficacy of on mental, cognitive outcomes individuals disorders; b) potential neurobiological, psychosocial behavioral mechanisms underlying observed effects; c) barriers facilitators successfully engage these interventions. Our systematic search identified 13 meta‐analyses high methodological quality (i.e., A Measurement Tool Assess Systematic Reviews, AMSTAR score ≥8) assessing as an adjunctive treatment, which included 256 randomized clinical trials (RCTs) 12,233 individuals. Large effect sizes were found improving attention children adolescents attention‐deficit/hyperactivity disorder (ADHD); reducing depressive symptoms children, adults body mass index schizophrenia. Moderate reductions hyperactivity, impulsivity anxiety, improvements executive social functioning ADHD; reduction anxiety improved psychological life cardiovascular fitness daily living skills, overall cardiorespiratory schizophrenia; older cognition functional mobility dementia. There is, date, no meta‐analytic first‐line treatment disorder. Five meta‐analyses, including 89 RCTs 4,575 individuals, investigated mechanisms. very preliminary circulating levels kynurenine, growth hormone, tumor necrosis factor‐alpha brain‐derived neurotrophic factor major No could be or Based 15 umbrella reviews, covering 432 studies 48 guidelines, six implementation strategies, along most evidence‐based change techniques support them, identified. Recommendations research area finally formulated.

Language: Английский

---

Big data for neuroscience in the context of predictive, preventive, and personalized medicine

The EPMA Journal, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 23, 2024

Language: Английский

---