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

2016 Impact Factor Available summer 2017
2013 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
Year

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: Brief and repetitive episodes of perceptual changes, termed paroxysmal perceptual alteration (PPA), have been described in association with antipsychotic treatment. We report a case of paranoid schizophrenia who had such perceptual changes akin to PPA for 15 years, that was not related to antipsychotic treatment. There was a rapid resolution of PPA following treatment with low dose clonazepam.
    No preview · Article · Jan 2012 · Psychopharmacology bulletin
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    ABSTRACT: Premenstrual psychosis has been described as a psychotic condition beginning shortly before, or during menstruation, in adolescent girls and young women. In this article, we present a case that developed sudden onset psychosis a few days before menstruation which resolved completely upon menstrual bleeding. Importantly, the recovery from psychotic symptoms was independent of antipsychotic treatment. A 30 year-old female was diagnosed with disorganized type schizophrenia ten years prior to this case study. She first suffered from auditory hallucination and persecutory delusion after her first menstrual cycle when she was in elementary school. She was treated with oral haloperidone 20 mg per day. The psychotic symptoms were frequently recurrent and her family thought the recurrence was due to poor drug compliance. The patient then started to receive long term injections of risperidone one year ago. It was discontinued because of the lack of efficacy. Aripiprazole 10 mg per day was prescribed and thereafter titrated to 20 mg per day. During the following, vivid auditory hallucination, self-talking and self-laughing were frequently noted. There was no treatment effect of aripiprazole on these psychotic symptoms. In this case antipsychotic treatment was continuously received, including haloperidone, long term injection of risperidone and aripiprazole.However, psychotic features were still recurrent even in the presence of antipsychotic treatment. This case report suggests that cyclic psychoses associated with the menstrual cycle may be a specific entity, not included under the recognized functional psychoses. In some cases, these psychoses could be classified as a subgroup of premenstrual syndromes.
    No preview · Article · Jan 2012 · Psychopharmacology bulletin
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    ABSTRACT: Objectives: Despite clozapine's superior clinical efficacy in Treatment Resistant Schizophrenia (TRS), its adverse effects, need for periodic leukocyte monitoring, cost and variable clinical outcomes make the therapeutic decision making process difficult and mandate a clinical need to predict its treatment response. Hence, we investigated various clinical variables associated with treatment responses and adverse events of clozapine in TRS. Experimental Design: We assessed socio-demographic and clinical profiles, premorbid adjustment, traumatic life events, cognition, disability, psychopathology and serum clozapine levels of 101 patients with TRS on stable dose of clozapine using the following instruments: Brief Psychiatric Rating Scale, Abnormal Involuntary Movements Scale, Addenbrooke's Cognitive Examination-Revised, WHO Disability Assessment Scale-II, Childhood and Recent Traumatic Events Scale, and Premorbid Assessment Scale. We defined clozapine response a priori, adopted a casecontrol design framework and employed appropriate multivariate analyses. Principal Observations: Past history of catatonia (p= 0.005), smoking more than one pack/day (p = 0.008), hyper-somnolence (p = 0.03) and cognitive dysfunction (p = 0.007) were associated with non-response to clozapine. Outcome definitions of non-response to clozapine influenced its association with clinical predictors. Conclusions: Clinical variables are useful to predict response to clozapine. Smoking can be a potentially modifiable risk factor. Future longitudinal studies, investigating clinical and pharmacogenetic variables together, are desired.
    No preview · Article · Dec 2011 · Psychopharmacology bulletin
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    ABSTRACT: Objective: Vilazodone is a selective serotonin reuptake inhibitor and 5-HT1A receptor partial agonist approved for the treatment of major depressive disorder (MDD). This report summarizes the safety and tolerability of vilazodone 40 mg/day during shortand long-term treatment of adult MDD.Methods: Pooled data from two 8-week, doubleblind studies of vilazodone (n = 436) vs placebo (n = 433) and data from one 52-week, open-label study (n = 616, vilazodone only) were analyzed. Patients aged 18-70 with DSM-IV-TR-defined MDD received vilazodone or placebo (8-week studies only) once daily, with food, titrated to 40 mg/day over 2 weeks. Safety and tolerability assessments included adverse events (AEs), laboratory tests, vital signs, electrocardiograms, and weight. Results: The most common AEs in all studies were diarrhea, nausea, and headache. Vilazodone-associated AEs in the two 8-week studies, defined as an incidence rate of ≥5% in the vilazodone group and at least twice that for placebo, were diarrhea (28.0% vs 9.2%), nausea (23.4% vs 5.1%), and insomnia (6.0% vs 2.1%), with the majority reported as mild to moderate and <5% of those patients requiring concomitant (directed) treatment for these conditions. Discontinuation rates due to AEs were 7.1% (vilazodone) and 3.2% (placebo) in the 8-week studies and 20.7% in the 52-week study. Vilazodone had no clinically significant effects on vital signs, laboratory tests, or electrocardiograms. Conclusion: Vilazodone 40 mg/day was well tolerated during short- and long-term MDD treatment in these trials. Safety profiles associated with 8- and 52-week exposure were consistent.
    No preview · Article · Dec 2011 · Psychopharmacology bulletin
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    ABSTRACT: Adolescent conduct disorder (CD) is generally hard to manage clinically, as this population often refuses to take oral medications. Families and acquaintances of these adolescents usually suffer from extreme psychological, financial and social difficulties. Oral antipsychotics are the primary drugs of choice clinically, after behavioral treatments. Here we report a case with attention deficit hyperactivity disorder and conduct disorder who refuses to take any medications, was not eligible for behavioral treatments and was treated successfully with long acting risperidone.
    No preview · Article · Dec 2011 · Psychopharmacology bulletin
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    ABSTRACT: Aims: Given resource constraints in conducting clinical trials, it is critical that rater training focuses on scale items wherein standardization is most challenging. This analysis examined mood disorder symptom ratings submitted in an online rater training program conducted preparatory to the initiation of a multi-site, international mood disorder treatment trial. Ratings were entered online and analyzed for consistency and variability, and compared to established standards (Gold Consensus Ratings/ GCRs). Methods: Raters participated in web-based rater training on the Hamilton Depression Rating Scale (HAM-D), Montgomery Asberg Rating Scale (MADRS), and Young Mania Rating Scale (YMRS). Training included integration of didactic materials and videos of two bipolar depressed patients interviewed by two U.S. clinicians. Raters viewed the videos and rated the mood scales. Inter-rater agreement was assessed using Kappa statistics. Ratings between the raters and the GCRs for individual scale items were assessed using McNemar test for paired binomial proportions. Results: 194 raters from 16 countries, 80 sites and speaking 20 different languages participated. Interrater agreement on videos ratings ranged from substantial to moderate (HAM-D, Kappa video A =0.72, video B < 0.65, p= 0.001), (MADRS, Kappa = 0.65 and 0.47, p < 0.001), (YMRS, Kappa = 0.75, and 0.64, p < 0.001). There was no significant difference on agreement based upon on English proficiency, clinical experience, or by country. Scale items that differed from the GCR on the HAM-D were depressed mood, delayed insomnia, retardation, and anxiety (psychic). Items that differed on the MADRS were apparent sadness, inner tension, concentration difficulties, lassitude and inability to feel. Items that differed on the YMRS were irritability and disruptive behavior. Conclusions: Identification of specific rating scale items in which rater variability is greatest may facilitate training approaches that target these areas for more efficient training in international clinical trials.
    No preview · Article · Dec 2011 · Psychopharmacology bulletin
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    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.
    No preview · Article · Jan 2011 · Psychopharmacology bulletin
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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.
    No preview · Article · Jan 2011 · Psychopharmacology bulletin
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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.
    No preview · Article · Jan 2011 · Psychopharmacology bulletin
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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.
    No preview · Article · Jan 2011 · Psychopharmacology bulletin
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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.
    No preview · Article · Jan 2011 · Psychopharmacology bulletin
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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.
    No preview · Article · Jan 2011 · Psychopharmacology bulletin
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    ABSTRACT: This study evaluated the efficacy of ramelteon for insomnia in adult subjects with ADHD. Experimental Design: For this randomized, double-blind, placebo-controlled crossover trial, 8 mg of ramelteon was given nightly, within three hours of bedtime, to ADHD-insomnia subjects confirmed by DSM-IV-TR, ADHD-RS, MINI, and clinical interview). All subjects underwent two weeks each of ramelteon and placebo. Objective sleep measures were obtained by actigraphy. Subjective measures included: the Epworth Sleepiness Scale (ESS) and ADHD-RS. Principal observations: Of 36 subjects entering the study, 58% met criteria for circadian rhythm sleep disorder (CRSD), delayed sleep phase type. During ramelteon period, mid-sleep time, an indicator of circadian phase, occurred significantly earlier, by ~45 minutes compared to placebo period. An association was noted between the magnitude of the sleep phase advance and the timing of ramelteon administration in relationship to sleep start time, but did not reach statistical significance; maximal efficacy was noted 1.5 hours before bedtime. Paradoxically, ramelteon marginally, but significantly increased sleep fragmentation and ESS scores compared to the placebo state. Conclusions: Ramelteon is efficacious in maintaining an earlier sleep/wake cycle in adults with ADHD and CRSD but can have paradoxical fragmenting effects on sleep and exacerbate daytime sleepiness. In the presence of a circadian rhythm disorder, the usual dosing and timing parameters for ramelteon need to be carefully considered.
    No preview · Article · Jan 2011 · Psychopharmacology bulletin