Univ., Diss.--Halle, 2004.

Zugl.: Regensburg, Univ., Diss., 2009

Ziel: Das Ziel dieser retrospektiven, naturalistischen Studie ist zum einen die Untersuchung der Zusammenhänge von Dosierung und Serumkonzentration, Serumkonzentration und Therapieeffekt sowie von Serumkonzentration und unerwünschten Arzneimittel-Wirkungen (UAW) bei an Schizophrenie erkrankten Kindern und Jugendlichen unter Risperidon-Therapie. Zum anderen soll die Anwendbarkeit des therapeutischen Serumkonzentrations-Referenzbereichs von Erwachsenen für Kinder und Jugendliche untersucht werden. Methode: Die von mehreren Kliniken in den Jahren 2005 – 2009 erhobenen Daten von 40 Kindern und Jugendlichen, die mittels des Therapeutischen Drug Monitorings überwacht wurden, wurden retrospektiv ausgewertet. Die gemessenen Serumkonzentrationen erfolgten im Steady State und beziehen sich auf die Summe von Risperidon und 9-hydroxy-Risperidon (aktive Menge). Die Beurteilung der Therapieeffekte erfolgte mittels der CGI-C-Unterskala (Clinical Global Impression of Change), die der UAW mithilfe der UKU-Skala (Udvalg for Kliniske Undersøgelser). Ergebnis und Fazit: Es zeigt sich eine signifikante, positive Korrelation zwischen der Tagesdosierung und der Serumkonzentration und keine signifikante Korrelation zwischen der Serumkonzentration und dem Therapieeffekt bzw. den UAW. Die Ergebnisse dieser Arbeit liefern erste Hinweise für einen möglicherweise niedrigeren therapeutischen Referenzbereich für an Schizophrenie erkrankten Kindern und Jugendlichen unter Risperidon-Behandlung. Aufgrund der Limitationen des naturalistischen Studiendesigns ist der vorgeschlagene Referenzbereich eine richtungsweisende Empfehlung. Weitere Studien mit größeren Stichprobenzahlen sind nötig um diese Ergebnisse zu validieren. / Objective: The aim of this retrospective, naturalistic study is on the one hand the examination of the relationships between dosage and serum concentration, serum concentration and therapeutic effect as well as serum concentration and side effects in schizophrenic children and adolescents during risperidone therapy. On the other hand the applicability of the adult therapeutical serum concentration reference range for children and adolescents shall be examined. Methods: From several clinics during the years 2005-2009 collected data of 40 children and adolescents was evaluated retrospective. These patients were monitored by therapeutic drug monitoring. Measured serum concentrations are steady state serum concentrations and refer to the sum of risperidone and 9-hydroxy-risperidone (active moiety). Therapeutic effects were assessed by the CGI-C-subscale (Clinical Global Impression of Change) and side effects by the UKU-scale (Udvalg for Kliniske Undersøgelser). Results and Conclusion: There was a significant positive correlation between dosage and serum concentration and no significant correlation between serum concentration and therapeutic effect respectively side effects. The results of this study indicate a possibly lower therapeutic reference range for schizophrenic children and adolescents during risperidone therapy. Because of the limitations of the naturalistic study design, the suggested reference range is a trend-setting recommendation. Further studies with greater sample sizes are needed to validate these results.

Zugl.: Regensburg, Universiẗat, Diss., 2009.

<p>Cilj: U istraživanju je posmatrana učestalost agresivnosti i hostilnosti kod osoba sa shizofrenim poremećajem, zatim povezanost težine kliniĉke slike shizofrenog poremećaja sa pojavom i stepenom agresivnosti i hostilnosti, povezanost doze ordiniranih antipsihotika sa stepenom agresivnosti i hostilnosti, kao i razlika u specifiĉnoj antiagresivnoj i antihostilnoj efikasnosti između risperidona i klozapina. Materijal i metode: Ova opservaciona studija je uključila 110 hospitalno lečenih bolesnika sa dijagnozom shizofrenog poremećaja koji su na prijemu u bolnicu imali vrednost ajtema P7 (hostilnost) skale PANSS &ge; 3 i vrednost skale MOAS &ge; 3. Bolesnici su procenjivani skalama PANSS i MOAS svakih sedam dana tokom njihovog bolničkog lečenja. Rezultati: Hostilnost i agresivnost su kao simptomi prisutni kod jedne trećine bolesnika sa dijagnozom shizofrenog poremećaja, a intenziteti hostilnosti i agresivnosti nisu povezani sa težinom kliničke slike poremećaja. Visine doza inicijalno ordiniranih antipsihotika su upravo srazmerne stepenu hostilnosti i agresivnosti bolesnika. Utvrđeno je da postoji specifično antiagresivno i antihostilno dejstvo i klozapina i risperidona, koje je nezavisno od njihovog antipsihotičnog dejstva, a klozapin je tokom posmatranog perioda imao bolju antihostilnu efikasnost. Zaključak: Agresivnost i hostilnost predstavljaju često prisutnu, značajnu, ali nezavisnu dimenziju shizofrenog poremećaja, a izbor antipsihotika se pored antipsihotične efikasnosti mora zasnivati i na njihovoj specifičnoj antiagresivnoj efikasnosti.</p> / <p>Objective: Frequency of aggression and hostility was observed in patients with schizophrenia, as well as the connection of symptom&rsquo;s severity with the appearance and level of aggression and hostility. The connection between the applied doses of antipsychotics with the level of aggression and hostility was observed, as well as differences in the specific antiagressive and antihostile efficacy of risperidone and clozapine. Materials and Methods: This observational study involved 110 hospitalized patients diagnosed with schizophrenia who had scores &ge; 3 on item P7 (hostility) of PANSS scale and score &ge; 3 on MOAS scale. Patients were evaluated every seven days during their hospitalization. Results: Hostility and aggression were present in one-third of schizophrenic patients on their hospital admission and their intensity was not related to the severity of the symptoms of schizophrenia. The dose of initially administered antipsychotics was proportional to the level of patient&rsquo;s hostility and aggression. It has been found that there is a specific antiaggressive and antihostile efficacy of clozapine and risperidone, which is independent of their antipsychotic efficacy, and that clozapine has a better antihostile efficacy during the observed period. Conclusion: Aggression and hostility are often present, important, but an independent dimension of schizophrenia, and the selection of antipsychotic must be based on it&rsquo;s specific antiaggressive efficacy, in addition to it&rsquo;s antipsychotic efficacy.</p>

Chronic sensitization of dopamine D2/D3 receptors by agonist quinpirole (QNP) induces compulsive checking behaviour in rats, which is considered an animal model of obsessive-compulsive disorder (OCD). Previous study revealed deficit in cognitive flexibility in QNP sensitized rats. This thesis focused on determining if this cognitive flexibility deficit is ameliorated by co-administration of clomipramine (CMI), risperidone (RIS) or combination of both (CMI+RIS) to QNP treatment. Aversively motivated active place avoidance task on a Carousel maze with reversal was used. The number of entrances into a to-be-avoided shock sector was evaluated as measure of performance. Six treatment groups were used: control group, QNP group, CMI group, QNP/CMI combination, QNP/RIS combination and QNP/CMI/RIS combination. Surprisingly, when compared alone, significantly worse acquisition was observed for QNP group compared to control group. However, similarly to previous study, QNP group had a worse performance in a first reversal session compared to control group. When all groups were compared, only QNP/CMI group had worse initial learning compared to control group. In reversal learning, only QNP treated group had a significantly more entrances than control group in first reversal session. Results suggest that co-treatment...