Increased Mortality in Elderly Patients with Dementia-Related Psychosis
Elderly patients with dementia-related psychosis treated with antipsychotic drugs
are at an increased risk of death. Analyses of seventeen placebo-controlled trials
(modal duration of 10 weeks), largely in patients taking atypical antipsychotic
drugs, revealed a risk of death in drug-treated patients of between 1.6 to 1.7 times
the risk of death in placebo-treated patients. Over the course of a typical 10-week
controlled trial, the rate of death in drug-treated patients was about 4.5%,
compared to a rate of about 2.6% in the placebo group. Although the causes of
death were varied, most of the deaths appeared to be either cardiovascular (e.g.,
heart failure, sudden death) or infectious (e.g., pneumonia) in nature.
Observational studies suggest that, similar to atypical antipsychotic drugs,
treatment with conventional antipsychotic drugs may increase mortality. The
extent to which the findings of increased mortality in observational studies may be
attributed to the antipsychotic drug as opposed to some characteristic(s) of the
patients is not clear. Perphenazine is not approved for the treatment of patients
with dementia-related psychosis (see WARNINGS).
Media Articles Related to Perphenazine
Clozapine vs the Rest for Treatment-Refractory Schizophrenia
Source: Medscape Pharmacists Headlines [2017.02.24]
Dr Peter Yellowlees talks about clozapine vs first- and second-generation antipsychotics in treatment-refractory schizophrenia.
Is insufficient weight gain during pregnancy associated with schizophrenia spectrum disorders in children later in life?
Source: Pregnancy / Obstetrics News From Medical News Today [2017.02.24]
Insufficient weight gain during pregnancy was associated with increased risk for nonaffective psychosis - or schizophrenia spectrum disorders - in children later in life in a study that used data...
Little Weight Gain in Pregnancy Tied to Schizophrenia Risk in Kids: Study
Source: MedicineNet Birth Defects Specialty [2017.02.23]
Title: Little Weight Gain in Pregnancy Tied to Schizophrenia Risk in Kids: Study
Category: Health News
Created: 2/22/2017 12:00:00 AM
Last Editorial Review: 2/23/2017 12:00:00 AM
Source: MedicineNet Schizophrenia Specialty [2017.02.22]
Category: Symptoms and Signs
Created: 7/24/2014 12:00:00 AM
Last Editorial Review: 2/22/2017 12:00:00 AM
B vitamins may improve schizophrenia symptoms
Source: Nutrition / Diet News From Medical News Today [2017.02.16]
The first meta-analysis of its kind reviews data from 18 clinical trials to conclude that B vitamins have a positive effect on schizophrenia symptoms.
Published Studies Related to Perphenazine
Impact of second-generation antipsychotics and perphenazine on depressive symptoms in a randomized trial of treatment for chronic schizophrenia. [2011.01]
CONCLUSIONS: We found no differences between any second-generation antipsychotic and the first-generation antipsychotic perphenazine and no support for the clinical practice recommendation, but we did detect a signal indicating a small potential difference favoring quetiapine over risperidone only in patients with an MDE at baseline. (c) Copyright 2011 Physicians Postgraduate Press, Inc.
Employment outcomes in a randomized trial of second-generation antipsychotics and perphenazine in the treatment of individuals with schizophrenia. [2008.04]
Employment has been increasingly recognized as an important goal for individuals with schizophrenia. Previous research has shown mixed results on the relationship of specific antipsychotic medications to employment outcomes, with some studies finding greater benefits for second-generation antipsychotic medications (SGAs) over first-generation antipsychotic medication (FGAs)...
CYP2D6 and DRD2 genes differentially impact pharmacodynamic sensitivity and time course of prolactin response to perphenazine. [2007.11]
OBJECTIVES: We observed that CYP2D6 contributes to pharmacodynamic tissue sensitivity to perphenazine as measured by the areas under the curve (AUCs) expressed as a ratio (prolactin-AUC0-6/perphenazine-AUC0-6) in Chinese Canadians [Pharmacogenetics and Genomics 2007; 17:339-347]. As genetic heterogeneity in drug targets can influence drug response, we sought to further evaluate the contribution of CYP2D6 to pharmacodynamic sensitivity in our previous study sample in tandem with DRD2, the primary molecular target for perphenazine... CONCLUSIONS: CYP2D6 seems to be an independent contributor to pituitary pharmacodynamic tissue sensitivity to perphenazine after accounting for DRD2 functional polymorphisms. The A1 allele of the Taq1A polymorphism was previously shown to decrease D2 receptor density in vitro and in neuroimaging studies in vivo. At a given antipsychotic dose, individuals with A1 allele might thus achieve a higher DRD2 antipsychotic occupancy, which is consistent with an increased prolactin elevation in the A1/A1 genotype in this study. These findings provide a basis for further studies on the endogenous substrates of CYP2D6 and the rational selection of candidate genes for long-term consequences of antipsychotic-induced hyperprolactinemia (e.g. susceptibility to breast and prostate cancers).
CYP2D6 genotype in relation to perphenazine concentration and pituitary pharmacodynamic tissue sensitivity in Asians: CYP2D6-serotonin-dopamine crosstalk revisited. [2007.05]
OBJECTIVES: Hyperprolactinemia is a common side effect of first-generation antipsychotics mediated by antagonism of dopaminergic neurotransmission in the pituitary. Most first-generation antipsychotics are metabolized by CYP2D6 in the liver. Further, CYP2D6 is expressed in the human brain as a 5-methoxyindolethylamine O-demethylase potentially contributing to regeneration of serotonin from 5-methoxytryptamine. As dopaminergic neurotransmission is subject to regulation by serotonin, CYP2D6 may exert a nuanced (serotonergic) influence on dopaminergic tone in the pituitary. CYP2D6*10 is an allele associated with reduced enzyme function and occurs in high frequency (about 50%) in Asians. We prospectively evaluated significance of CYP2D6 genetic variation for prolactin response to perphenazine (a model first-generation antipsychotic) in Asians... CONCLUSIONS: CYP2D6 genotype is a significant contributor to perphenazine concentration in Chinese-Canadians. Importantly, prolactin response, when normalized per unit perphenazine concentration, appears to be blunted in volunteers homozygous for CYP2D6*10. We suggest that CYP2D6 genetic variation may potentially influence pharmacodynamic tissue sensitivity in the pituitary, presumably through disposition of an endogenous substrate (e.g. 5-methoxytryptamine).
Effectiveness of olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia after discontinuing perphenazine: a CATIE study. [2007.03]
CONCLUSIONS: Among this group of patients with chronic schizophrenia who had just discontinued the older antipsychotic perphenazine, quetiapine and olanzapine were more effective than risperidone, as reflected by longer time to discontinuation for any reason. In the context of other results from the CATIE study, the effectiveness and acceptability of antipsychotic drugs appears to vary considerably according to clinical circumstances.
Clinical Trials Related to Perphenazine
Lurasidone Effects on Tissue Glutamate in Schizophrenia [Recruiting]
24 individuals with schizophrenia or schizoaffective disorders, who are currently considered
stable, will be recruited, screened for entry criteria into a blinded study with a 4-week
randomization to either lurasidone, haloperidol, or perphenazine to examine
glutamate-related outcomes with lurasidone as compared to haloperidol and perphenazine.
Reducing Weight Gain and Improving Metabolic Function in Children Being Treated With Antipsychotics [Completed]
This study will test the effectiveness of two different treatments for children and
adolescents who have gained weight on their antipsychotic medications.
Comparison of Optimal Antipsychotic Treatments for Adults With Schizophrenia [Completed]
This study will compare the safety and effectiveness of three different antipsychotic
medications, as well as the use of other medications to limit treatment side effects, in
adults with schizophrenia.
A Positron Emission Tomography (PET) Study to Assess the Degree of Dopamine-2 (D2) Receptor Occupancy in the Human Brain After Single Doses of BL-1020 or Perphenazine in Healthy Male Subjects Using [11C]Raclopride as PET Tracer [Completed]
A Double-Blind, Controlled Study of Aripiprazole in Co-Morbid Schizophrenia and Cocaine Dependence [Recruiting]
The purpose of this study is to gather systematic clinical data on whether aripiprazole, a
partial dopamine agonist, beneficially affects schizophrenia plus cocaine dependence
subjects. Since aripiprazole has established effects against schizophrenia, the study
focuses on whether aripiprazole concurrently reduces co-morbid cocaine dependence in
schizophrenia plus cocaine dependence sufferers compared to a standard typical antipsychotic
treatment (perphenazine). The working hypothesis states that subjects in the aripiprazole
treatment arm of the study will give fewer cocaine positive urine specimens as compared to
the perphenazine control arm.
Reports of Suspected Perphenazine Side Effects
Completed Suicide (5),
Decreased Appetite (5),
Appendicitis Perforated (4),
Intentional Self-Injury (4),
Intestinal Perforation (4),
Maternal Exposure During Pregnancy (4),
Agitation (3), more >>