Efficacy, Acceptability, and Safety of Atypical Antipsychotics in First Episode Schizophrenia

Achaia Taltoan, Mercer University College of Pharmacy

The American Psychiatric Association (APA) schizophrenia guidelines recommend all second-generation (“atypical”) antipsychotics as first-line treatment for first episode schizophrenia. [1] Unlike the APA guidelines, the 2009 schizophrenia PORT statements recommend risperidone, quetiapine, aripiprazole, and ziprasidone as first line therapy but not olanzapine due to the associated metabolic side effects. [2]

While trials such as the EUFEST and the CATIE trial have compared second-generation antipsychotics to first-generation antipsychotics, there is a lack of guidance whether one second-generation antipsychotic is better than the other in certain situations for the treatment of first episode schizophrenia. [3] This trial attempts to provide data to enhance the understanding of the efficacy, discontinuation rate, and adverse events of the second-generation antipsychotics in comparison with one another.

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The Effect of Adding Lorazepam to Haloperidol on Agitated Delirium in Patients with Advanced Cancer

Kayla Peltier, Mercer University College of Pharmacy

Delirium has been identified as the most common serious neuropsychiatric complication in cancer patients. First-line treatment for delirium is often non-pharmacological and includes re-orienting the patient frequently, encouraging cognitively stimulating activities, avoiding immobility if possible, and promoting good sleep patterns and sleep hygiene. If non-pharmacological therapies are not effective or the patient is displaying severe agitation and poses a risk to self-harm or harm others, then treatment with pharmacological agents (including antipsychotic and sedating medications) may be considered. [1]

The authors of the study state that while antipsychotics and benzodiazepines are often used to treat delirium, the use of benzodiazepines is controversial due to a lack of adequate, well-controlled randomized trials. Therefore, this study aims to compare the effect of lorazepam to placebo as an adjuvant to haloperidol therapy in patients with agitated delirium in the setting of advanced cancer. [2]

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