Psychopharmacology bulletin (Psychopharmacol Bull)

Publisher: National Clearinghouse for Mental Health Information (U.S.); National Institute of Mental Health (U.S.). Psychopharmacology Research Branch; International Reference Center on Psychotropic Drugs (U.S.); National Institute of Mental Health (U.S.). Pharmacologic and Somatic Treatments Research Branch; National Institute of Mental Health (U.S.). Division of Clinical Research; All authors

Current impact factor: 0.50

Impact Factor Rankings

2015 Impact Factor Available summer 2016
2013 / 2014 Impact Factor 0.5
2011 Impact Factor 1.354
2000 Impact Factor 2.809
1999 Impact Factor 2.245
1998 Impact Factor 2.59
1997 Impact Factor 1.816

Impact factor over time

Impact factor

Additional details

5-year impact 0.00
Cited half-life >10.0
Immediacy index 0.00
Eigenfactor 0.00
Article influence 0.00
Website Psychopharmacology Bulletin website
Other titles Psychopharmacology bulletin
ISSN 0048-5764
OCLC 1643323
Material type Government publication, National government publication, Periodical
Document type Journal / Magazine / Newspaper

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Clozapine has been serving as the gold standard medication for patients with treatment-resistant schizophrenia who failed to respond to other antipsychotics. However, factors affecting response to this medication have not been comprehensively reviewed recently. In order to find factors associated with response to clozapine in schizophrenia, a literature search was conducted using PubMed through January 2011 with keywords of clozapine, response, and schizophrenia. Cross-referencing of relevant articles was also performed. Factors were arbitrarily classified into the following: demographic/clinical, oral dosage/pharmacokinetic, biochemical, (electro)physiological, genetic, imaging, and combinations. A synthesis from 280 articles indicated that demographic and clinical variables such as high baseline symptoms and low premorbid functioning have not been particularly useful in predicting response to clozapine. Pharmacokinetic evidence points to a threshold clozapine level of 350 ng/ml but in a context of significant inter- as well as intra-individual variability. Pharmacokinetic perspectives appear to have more implication in special situations including poor response, suspected toxicity and nonadherence. A number of laboratory-based studies have reported on many potential candidates for response prediction to clozapine, however, reproducibility, specificity, robustness of the findings, as well as clinical feasibility and cost-effectiveness all pose a significant practical challenge, in relation with the fact that pathophysiological bases of treatment resistance in schizophrenia largely remain to be elucidated. No unequivocal factors to clozapine response were found despite a relatively rich body of the literature, which calls for more works on this important topic. Clozapine level of 350 ng/ml appears to be useful in case of nonresponse.
    Psychopharmacology bulletin 01/2011; 44(1):32-60.
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    ABSTRACT: Risperidone is associated with hyperprolactinemia and its consequent symptoms such as gynecomastia, galactorrhea and sexual dysfunction in adults, and less so in adolescents. Rarely, serotonin reuptake inhibitors are also associated with such adverse effects. We report a case of gynecomastia and galactorrhea in an adolescent male while on a combination of risperidone and fluvoxamine, although the serum prolactin was within normal range.
    Psychopharmacology bulletin 01/2011; 44(1):70-3.
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    ABSTRACT: Although numerous reports suggest that different atypical antipsychotics can exacerbate or induce (de novo) obsessive-compulsive symptoms, there is no report of the development of ego-dystonic, suicidal obsessions during treatment with these medications. Here, the authors report the first case of clozapine-induced suicidal obsessions. The authors report a case of a patient diagnosed with bipolar disorder and who developed suicidal obsessions in the weeks after the dose of clozapine was increased from 150 mg/day to 300 mg/day. Symptoms quickly resolved after the treatment with clozapine was changed to the treatment with quetiapine and sodium valproate. Suicidal obsessions decreased promptly, within a few days, and disappeared completely when the dose of clozapine was 100 mg/day, quetiapine 600 mg/day, and sodium valproate 900 mg/day, 16 days after the initiation of changes in the medications. The case report emphasizes the crucial need of differentiation between genuine suicidal desires and ego-dystonic suicidal obsessions. The authors suggest that in similar cases a change in antipsychotic medications to those with stronger antidopaminergic properties and lower 5HT2 receptor affinity should be considered, but also assume that the use of sodium valproate in treatment of obsessive-compulsive symptoms deserves further study.
    Psychopharmacology bulletin 01/2011; 44(1):65-9.
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    ABSTRACT: This is the first multicenter, double blind, randomized, placebo-controlled trial to evaluate the safety and efficacy of adjunctive zonisamide for the treatment of bipolar mania or mixed state. One hundred four patients with Bipolar Disorder, Type I, II or NOS, in a manic, hypomanic or mixed state of illness were randomized to either adjunctive zonisamide or placebo. The study consisted of three phases: a 7 to 30 day screening and stabilization phase, 6 weeks of blinded treatment and a 1 to 3 week discontinuation phase. The primary outcome variable for manic and hypomanic patients was the Young Mania Rating Scale (YMRS) both the YMRS and Montgomery Asberg Depression Rating Scale (MADRS) served as primary outcome variables for patients in mixed states. Secondary outcome measures included the Clinical Global Impression for Bipolar Disorder (CGI-BP), the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and an a priori analysis of response and remission. Metabolic parameters including weight, waist-hip ratio, body mass index, fasting glucose, cholesterol and triglyceride levels were also analyzed. Side effects were measured using the SAFTEE. There were no statistically significant differences for any of the primary or secondary outcome measures between zonisamide and placebo-treated patients. In contrast to previous studies that suggested efficacy of adjunctive zonisamide in bipolar mania or mixed state, these results were not confirmed in this double blind controlled study.
    Psychopharmacology bulletin 01/2011; 44(1):5-17.
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    ABSTRACT: This paper reviewed which rating scales past studies adopted as an outcome measure in clinical trials for schizophrenia, for which a consensus has been lacking. A PubMed search was conducted using keywords 'outcome', 'rating scales' and 'schizophrenia'. Studies published in 1999, 2004 and 2009 were examined to globally see if a trend has changed over the last decade. One-hundred fifty articles were inspected. As for psychopathology, the positive and negative syndrome scale (PANSS) has been by far the most frequently utilized scale (46%, 79%, and 78% in the respective years), followed by the brief psychiatric rating scale. Affective/anxiety symptoms have been only rarely recorded Extrapyramidal symptoms have been assessed mostly with the Simpson Angus scale (SAS), more frequently in combination with the abnormal involuntary movement scale (AIMS) and Barnes akathisia scale (BARS) recently. Non-motor adverse effects have been typically reported without a usage of formal rating scales. Depending on the interest of investigation, other critical domains of the illness including functioning, cognition and subjective perspectives have been sporadically reported through the rating scales. The assessment scales were similarly utilized across the years, except for a numerical rise in scale utilization to rate the latter three domains in 2009. The PANSS and set of AIMS, BARS and SAS, which are expected to take about 60 minutes to complete, are frequently utilized and may be regarded as a 'standard' in clinical trials for schizophrenia. Clinical implication of the findings and practical challenges with the existing scales are discussed.
    Psychopharmacology bulletin 01/2011; 44(1):18-31.
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    ABSTRACT: Due to lack of laboratorial investigations in psychiatric practice, tests of treatment are often used to aid diagnosis. This article provides examples of test of treatment in psychiatric practice and outlines their limitations.
    Psychopharmacology bulletin 01/2011; 44(1):61-4.
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    ABSTRACT: Dialogues Time to Talk (Dialogues) is a care management program that provides additional follow-up care and patient education for outpatients with major depressive disorder (MDD) starting venlafaxine extended release (ER) therapy. This study examined the effect of the Dialogues program on patient treatment satisfaction. In this 6-month, open-label study, primary care patients with MDD received usual care and were randomly assigned to venlafaxine ER (75 to 225 mg/d) either alone or in combination with the Dialogues program (venlafaxine ER + D). The primary outcome was patient treatment satisfaction on day 112, measured by the 10- point Satisfaction with Depression Care Scale (SDCS). Secondary efficacy outcomes included the 17-item Hamilton Rating Scale for Depression (HAM-D17) total score, response (≥50% decrease from baseline HAM-D17 score), and remission (HAM-D17 ≤ 7). The modified intent-to-treat population included 263 patients in the venlafaxine ER group and 257 in the venlafaxine ER+D group. The percentage of patients with an SDCS "very satisfied" score (≥8) at day 112 was not significantly different in the venlafaxine ER and venlafaxine ER+D groups (63% and 58%, respectively; P = 0.22). No significant differences were found on any secondary outcomes. Among primary care patients starting venlafaxine ER for MDD, participation in the Dialogues program did not have a statistically significant effect on patient treatment satisfaction.
    Psychopharmacology bulletin 09/2010; 43(2):28-44.
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    ABSTRACT: Drug induced mania is sometimes associated with drug that are primarily not used for central nervous system effects. Here we report a manic episode during the treatment of leukemia with various agents in an adolescent with diagnosis of high functioning autism. In this case, most likely candidates to induce a manic episode were dexamethazone, a corticosteroid used in the treatment of T-ALL, cyclophosphamide and cotrimoxazole. Although literature on mood disorders associated with corticosteroids exceeds that of cyclophosphamide and cotrimoxazole, an absolute causal drug cannot be stated.
    Psychopharmacology bulletin 09/2010; 43(2):82-5.
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    ABSTRACT: To evaluate the value of early improvement to predict treatment outcome in patients with bipolar depression. Data were pooled from two aripiprazole, 8-week, randomized, double-blind, placebo-controlled trials in patients with bipolar depression without psychotic features to determine whether early improvement (≥20% reduction in Montgomery-Åsberg Depression Rating Scale (MADRS) Total score at Week 2 or 3) predicts later response (≥50% MADRS Total score reduction at Week 8) or remission (MADRS Total ≤10 at Week 8). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated (LOCF). Univariate and multivariate logistic regression models were used to evaluate early improvement and baseline demographic/clinical characteristics as predictors of response/remission. In total, 311 patients were randomized to placebo and 306 to aripiprazole. Predictive values of early improvement (≥20% MADRS Total score reduction) for remission with aripiprazole at Week 2/3, respectively, were: sensitivity 83%/94%; specificity 41%/33%; PPV 44%/45%; NPV 81%/91%. The corresponding values with placebo were as follows: sensitivity 70%/84%; specificity 60%/51%; PPV 50%/51%; NPV 77%/84%. Univariate linear regression showed that early improvement (≥15%, ≥20%, ≥25%, ≥30% at Week 3) was a significant potential predictor of remission. Absence of early improvement after 3 weeks of treatment reliably predicted non-response/non-remission at study endpoint with high sensitivity and NPV. In patients with <20% improvement after 21 days of aripiprazole monotherapy, treatment should be modified, as continued use is unlikely to result in response/remission. Clinical decision-making to optimize treatment course in bipolar I depression may be appropriate after as little as 2 weeks and certainly within the first 3 weeks of treatment.
    Psychopharmacology bulletin 09/2010; 43(2):5-27.
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    ABSTRACT: Previous naturalistic observational studies have produced mixed results concerning the effectiveness of clozapine on hospitalization, partly because the decision to place a patient on clozapine versus another antipsychotic has been confounded with the known efficacy of clozapine over other antipsychotics. To examine the effectiveness of clozapine compared to other antipsychotic drugs in delaying hospitalization in routine clinical practice. Consecutive patients with schizophrenia or schizoaffective disorders registered to start on clozapine in one English mental health service over a six-year period were followed up for 2 years from the time of discharge (index admission). Time to hospitalization was used to compare patients started and discharged on clozapine (CG = 126) and those registered to start on clozapine but subsequently discharged on other antipsychotics (OAG = 34) using Kaplan-Meier survival analysis. There were more hospitalizations with OAG 13 [38%] than CG = 27 [21%]. Time to hospitalization (25th centile) was 299 days in CG and 136 days in OAG among patients who were successfully discharged from hospital (x2 = 4.80, df = 1, p = 0.043). The time to hospitalization was delayed in CG versus other OAG when baseline differences in age, gender, marital status, previous forensic mental health service, case management and site of initiation were controlled [odds ratio (95% confidence intervals) = 1.87 (1.01, 4.33), p = 0.048]. Clozapine delays hospitalization in patients with treatment resistant schizophrenia if they are started on clozapine in the community or successfully discharged from hospital following their index admission.
    Psychopharmacology bulletin 09/2010; 43(2):67-81.
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    ABSTRACT: OBJECTIVE: The adrenergic beta-1 receptor gene (ADRB1) Ser49Gly and Arg389Gly variants differentially affect blood pressure response to beta-blocker therapy. Binding site prediction results for fluoxetine and paroxetine in a bioinformatics model estimated that each of these particular selective serotonin reuptake inhibitors (SSRIs) have high receptor affinity as an "Adrenergic (beta) Blocker," which was confirmed in vitro. This pilot study was conducted to understand the relationship between these "beta-blocking" SSRIs (fluoxetine and paroxetine) and cardiac vital signs (systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR)), when subjects are stratified by ADRB1 genotype. Previously ascertained DNA and clinical data was examined from 122 subjects recruited for a cross-sectional study of health and well being during SSRI pharmacotherapy. A multivariate linear regression analysis was used to determine which variables affected cardiac vital signs. There was a significant interaction between Arg389Gly variant status and "beta-blocking" SSRIs [p = 0.0353] in relation to SBP. Specifically in homozygous Arg389 subjects, those receiving "beta-blocking" SSRIs had significantly lower SBP (mean 104 mmHg) compared to the group taking other SSRIs (mean 122 mmHg) [p = 0.0437]. In these same homozygous Arg389 subjects, those receiving "beta-blocking" SSRIs also had lower HR (mean 60 bpm) compared to the other SSRIs (mean 79 bpm) [p = 0.00877]. Future prospective studies of this phenomenon are necessary to identify all genetic markers that can predict SSRI-associated cardiovascular effects that may be related to the SSRI discontinuation syndrome and potentially influence pharmacotherapy decisions.
    Psychopharmacology bulletin 02/2010; 43(1):11-22.
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    ABSTRACT: A naturalistic, prospective study analyzed the effectiveness of long-acting injectable risperidone (LAIR) in psychotic outpatients. All outpatients (n = 53), affected by Schizophrenia and other Psychotic Disorders, who have begun LAIR at the Mental Health Service of Modena from December 1, 2005 to December 1, 2006, were collected. Exclusion criteria: concomitant oral antipsychotic therapy at the 12th weeks (n = 16 patients) and treatment discontinuation (n = 12). The reasons of drop-out were analyzed. Clinical and demographic characteristics of outpatients (n = 25), motivations, implementation and adverse effects of LAIR treatment were evaluated. the improvement of symptoms (25% reduction of BPRS and CGI-S scale score from baseline) and functioning level (50% increase of GAF scale score from baseline) at 6th (T6) and 12th (T12) month of LAIR therapy. Secondary outcome: reduction of the hospitalization days during the 1-year LAIR treatment in comparison to the previous year ones of the same patients. The final BPRS, CGI-S and GAF scores both at T6 and T12 showed a statistically significant difference from baseline (p < 0.0001, t-test). The frequency of improved patients in BPRS, CGI-S and GAF scales were 60%, 68%, 52% at T6, and 72%, 54%, 56% at T12, respectively. Side effects were represented by weight increase (4%), orthostatic hypotension (8%) and EPS (4%). The hospitalization days were statistically significant reduced during the 1-year LAIR treatment in comparison to the previous year ones (p < 0.05, t-test). Our data, limited by the small sample and the naturalistic methodology, suggest that 1-year LAIR treatment may be effective and safe.
    Psychopharmacology bulletin 02/2010; 43(1):39-52.