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Article ; Online: Can the current schizophrenia construct endure?

Kelly, Deanna L / Buchanan, Robert W

2022 Volume 242, Page(s) 64–66

MeSH term(s)	Humans ; Schizophrenia ; Schizophrenic Psychology
Language	English
Publishing date	2022-01-20
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	639422-x
ISSN	1573-2509 ; 0920-9964
ISSN (online)	1573-2509
ISSN	0920-9964
DOI	10.1016/j.schres.2021.12.028
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Zs.A 2351: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Psychiatric pharmacist's role in overcoming barriers to clozapine use and improving management.

Kelly, Deanna L / Love, Raymond C

The mental health clinician

2019 Volume 9, Issue 2, Page(s) 64–69

Abstract: Clozapine is an antipsychotic that exhibits superior efficacy and effectiveness for those with schizophrenia and other serious mental illness. However, its side-effect profile and administrative burdens present challenges to its use. In the United States, ...

Abstract	Clozapine is an antipsychotic that exhibits superior efficacy and effectiveness for those with schizophrenia and other serious mental illness. However, its side-effect profile and administrative burdens present challenges to its use. In the United States, the medication is grossly underused even though it may improve outcomes and reduce costs. Current barriers to use include lack of prescriber knowledge and confidence, negative prescriber attitudes, special monitoring requirements, administrative factors, lack of clozapine on formularies, lack of support and infrastructure to use the medication within many health systems, and inadequate understanding or acknowledgement of clozapine prescribing and risks by policy makers and payers. Approaches using interprofessional models of care, which include pharmacists specializing in psychiatric care, can help meet the needs of patients receiving clozapine. This article lays out the big picture of barriers to clozapine and how psychiatric pharmacists could play a role in improving access.
Language	English
Publishing date	2019-03-01
Publishing country	United States
Document type	Journal Article
ISSN	2168-9709
ISSN (online)	2168-9709
DOI	10.9740/mhc.2019.03.064
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Article: Development of point-of-care testing devices to improve clozapine prescribing habits and patient outcomes.

Kalaria, Shamir N / Kelly, Deanna L

Neuropsychiatric disease and treatment

2019 Volume 15, Page(s) 2365–2370

Abstract: Although clozapine has demonstrated superior efficacy in patients with schizophrenia and other serious mental health illness, drug utilization rates are significantly low due to safety concerns and administration challenges. Previous research indicates ... ...

Abstract	Although clozapine has demonstrated superior efficacy in patients with schizophrenia and other serious mental health illness, drug utilization rates are significantly low due to safety concerns and administration challenges. Previous research indicates that current barriers to clozapine use include lack of confidence and knowledge by prescriber, therapeutic monitoring requirements, lack of support and infrastructure to for adequate monitoring and patient adherence, and inadequate understanding of clozapine's benefit-risk profile by policy makers and payers. One potential solution to optimizing clozapine therapy and improving clinical outcomes is the use of point-of-care testing (POCT) devices. Although the drug development process for currently used therapeutics is widely acknowledged, little is known regarding the development of POCT devices by the clinical community. The aim of this review is to provide a summary of the regulatory approval process and current availability of POCT devices for monitoring clozapine therapeutics. The potential role of POCT devices in clinical trials to inform personalized dosing strategies and improve patient outcomes will also be discussed.
Language	English
Publishing date	2019-08-20
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2186503-6
ISSN	1178-2021 ; 1176-6328
ISSN (online)	1178-2021
ISSN	1176-6328
DOI	10.2147/NDT.S216803
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Article ; Online: The hormonal effects of childhood trauma in adult women with and without schizophrenia.

Kulaga, Stephanie S / Wehring, Heidi J / Demyanovoich, Haley J / Rubin, Leah / Kelly, Deanna L

Schizophrenia research

2023 Volume 255, Page(s) 155–157

MeSH term(s)	Adult ; Humans ; Female ; Child ; Schizophrenia/complications ; Adverse Childhood Experiences ; Psychotic Disorders ; Child Abuse
Language	English
Publishing date	2023-03-28
Publishing country	Netherlands
Document type	Letter
ZDB-ID	639422-x
ISSN	1573-2509 ; 0920-9964
ISSN (online)	1573-2509
ISSN	0920-9964
DOI	10.1016/j.schres.2023.03.043
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Zs.A 2351: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Analysis of prolactin and sexual side effects in patients with schizophrenia who switched from paliperidone palmitate to aripiprazole lauroxil.

Kelly, Deanna L / Claxton, Amy / Bidollari, Ilda / Du, Yangchun

Psychiatry research

2021 Volume 302, Page(s) 114030

Abstract: One strategy to address hyperprolactinemia and associated sexual side effects in patients receiving antipsychotics is switching to an antipsychotic not associated with prolactin elevation (eg, aripiprazole). This post hoc analysis assessed prolactin ... ...

Abstract	One strategy to address hyperprolactinemia and associated sexual side effects in patients receiving antipsychotics is switching to an antipsychotic not associated with prolactin elevation (eg, aripiprazole). This post hoc analysis assessed prolactin concentrations and sexual side effects in an open-label prospective study of switching long-acting injectable antipsychotics from paliperidone palmitate (PP) to aripiprazole lauroxil (AL). Serum prolactin was measured throughout the study. Patient-reported sexual and endocrine side effects were assessed on the UKU Side Effect Rating Scale sexual function subscale and analyzed in study completers. Prior to starting AL treatment (screening), 49/50 (98%) patients had prolactin concentrations above the upper limit of normal (ULN; >13.13 ng/mL [males]; >26.72 ng/mL [females]). Six months after beginning AL treatment, prolactin levels were above ULN in 2/32 (6.3%) patients. Among 32 study completers, 81.3% reported sexual dysfunction in ≥1 domain at screening versus 56.3% at 6 months after starting AL treatment. Diminished sexual desire was the most common patient-reported sexual complaint at screening (46.9%); at 6 months, it was reported by 18.8%. In this post hoc analysis, the high levels of prolactin observed at screening decreased during AL treatment, and modest improvements in sexual side effects were evident in patients with schizophrenia.
MeSH term(s)	Antipsychotic Agents/adverse effects ; Aripiprazole/adverse effects ; Female ; Humans ; Hyperprolactinemia/chemically induced ; Hyperprolactinemia/drug therapy ; Male ; Paliperidone Palmitate/adverse effects ; Prolactin ; Prospective Studies ; Schizophrenia/drug therapy
Chemical Substances	Antipsychotic Agents ; Aripiprazole (82VFR53I78) ; Prolactin (9002-62-4) ; aripiprazole lauroxil (B786J7A343) ; Paliperidone Palmitate (R8P8USM8FR)
Language	English
Publishing date	2021-05-27
Publishing country	Ireland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	445361-x
ISSN	1872-7123 ; 1872-7506 ; 0925-4927 ; 0165-1781
ISSN (online)	1872-7123 ; 1872-7506
ISSN	0925-4927 ; 0165-1781
DOI	10.1016/j.psychres.2021.114030
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Article ; Online: Clozapine-associated renal failure: A case report and literature review.

Davis, Erica A K / Kelly, Deanna L

The mental health clinician

2019 Volume 9, Issue 3, Page(s) 124–127

Abstract: One of clozapine's unrecognized potential side effects is renal insufficiency and nephritis. Although most clinicians are aware of the possibility of clozapine-induced myocarditis, less is known about other inflammatory disorders due to clozapine ... ...

Abstract	One of clozapine's unrecognized potential side effects is renal insufficiency and nephritis. Although most clinicians are aware of the possibility of clozapine-induced myocarditis, less is known about other inflammatory disorders due to clozapine treatment. This patient was started on lithium and clozapine within 4 days of each other although lithium was discontinued after 7 days due to tremor. Routine labs showed an increase in serum creatinine, which was initially attributed to the recent lithium. However, the patient's kidney function continued to worsen, requiring discontinuation of clozapine despite a robust response to a low dose. Several years later, the patient's kidney function improved but has not returned to baseline. This literature review and case report illustrates the similarities in diagnostic presentation of clozapine-associated renal insufficiency as well as potential risk factors. More research should be conducted into the role concomitant sodium valproate and/or lithium play in the risk of clozapine-associated renal insufficiency.
Language	English
Publishing date	2019-05-10
Publishing country	United States
Document type	Case Reports
ISSN	2168-9709
ISSN (online)	2168-9709
DOI	10.9740/mhc.2019.05.124
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Article ; Online: Pilot study indicates that a gluten-free diet lowers oxidative stress for gluten-sensitive persons with schizophrenia.

Kim, Eunkyoung / Redwood, Sidney / Liu, Fang / Roche, Daniel J O / Chen, Shuo / Bentley, William E / Eaton, William W / Čiháková, Daniela / Talor, Monica V / Kelly, Deanna L / Payne, Gregory F

Schizophrenia research

2024 Volume 269, Page(s) 71–78

Abstract: One-third of people with schizophrenia have elevated levels of anti-gliadin antibodies (AGA IgG). A 5-week randomized double-blind pilot study was performed in 2014-2017 in an inpatient setting to test the effect of a gluten-free diet (GFD) on ... ...

Abstract	One-third of people with schizophrenia have elevated levels of anti-gliadin antibodies (AGA IgG). A 5-week randomized double-blind pilot study was performed in 2014-2017 in an inpatient setting to test the effect of a gluten-free diet (GFD) on participants with schizophrenia or schizoaffective disorder who also had elevated AGA IgG (≥ 20 U) but were negative for celiac disease. This earlier pilot study reported that the GFD-group showed improved gastrointestinal and psychiatric symptoms, and also improvements in TNF-α and the inflammatory cytokine IL-23. Here, we performed measurements of these banked plasma samples to detect levels of oxidative stress (OxSt) using a recently developed iridium (Ir)-reducing capacity assay. Triplicate measurements of these samples showed an Intraclass Correlation Coefficient of 0.84 which indicates good reproducibility. Further, a comparison of the OxSt measurements at the baseline and 5-week end-point for this small sample size shows that the GFD-group (N = 7) had lowered OxSt levels compared to the gluten-containing diet group (GCD; N = 9; p = 0.05). Finally, we showed that improvements in OxSt over these 5 weeks were correlated to improvements in gastrointestinal (r = +0.64, p = 0.0073) and psychiatric (r = +0.52, p = 0.039) symptoms. Also, we showed a possible association between the decrease in OxSt and the lowered levels of IL-23 (r = +0.44, p = 0.087), although without statistical significance. Thus, the Ir-reducing capacity assay provides a simple, objective measure of OxSt with the results providing further evidence that inflammation, redox dysregulation and OxSt may mediate interactions between the gut and brain.
Language	English
Publishing date	2024-05-14
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	639422-x
ISSN	1573-2509 ; 0920-9964
ISSN (online)	1573-2509
ISSN	0920-9964
DOI	10.1016/j.schres.2024.05.001
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Zs.A 2351: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Levels of prolactin and testosterone and associated sexual dysfunction and breast abnormalities in men with schizophrenia treated with antipsychotic medications.

Redman, Brianne / Kitchen, Chris / Johnson, Kirk W / Bezwada, Padma / Kelly, Deanna L

Journal of psychiatric research

2021 Volume 143, Page(s) 50–53

Abstract: Sexual dysfunction is one of the most bothersome adverse drug effects seen in men and women taking antipsychotic medications and negatively impacts medication adherence. Antipsychotic medications are associated with hyperprolactinemia, which is known to ... ...

Abstract	Sexual dysfunction is one of the most bothersome adverse drug effects seen in men and women taking antipsychotic medications and negatively impacts medication adherence. Antipsychotic medications are associated with hyperprolactinemia, which is known to contribute to sexual and hormonal side effects in men. However, testosterone also plays a key factor in male sexual function and may be affected by abnormal prolactin levels through gonadotropin-releasing hormone inhibition. This study was a pilot study undertaken to assess the prevalence of elevations in prolactin levels, related reductions in testosterone levels, associated symptoms of sexual dysfunction and breast abnormalities in male participants, and related distress to these symptoms in men taking prolactin-elevating antipsychotic medications. The study was conducted as a cross-sectional study. Our results showed a notably high prevalence of sexual side effects in this population, with gynecomastia occurring in 50% and penile-related symptoms in 73%. Additionally, we found elevated prolactin levels in 68% and low testosterone levels in 55% of our participants. This study was limited in its power due to a small sample size of 22 men and the lack of a control group. Still, even in our relatively small sample, we see a trend of hyperprolactinemia being associated with low testosterone and a significant correlation of low testosterone levels with penile-related symptoms. This suggests that testosterone plays a major role in the sexual side effects reported by men taking antipsychotics, although larger studies are needed to further categorize this relationship.
MeSH term(s)	Antipsychotic Agents/adverse effects ; Cross-Sectional Studies ; Female ; Humans ; Male ; Pilot Projects ; Prolactin ; Schizophrenia/drug therapy ; Testosterone
Chemical Substances	Antipsychotic Agents ; Testosterone (3XMK78S47O) ; Prolactin (9002-62-4)
Language	English
Publishing date	2021-08-18
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	3148-3
ISSN	1879-1379 ; 0022-3956
ISSN (online)	1879-1379
ISSN	0022-3956
DOI	10.1016/j.jpsychires.2021.08.022
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Article: A reduced-graphene oxide-modified microelectrode for a repeatable detection of antipsychotic clozapine using microliters-volumes of whole blood

Shukla, Rajendra P / Cazelles, Remi / Kelly, Deanna L / Ben-Yoav, Hadar

Talanta. 2020 Mar. 01, v. 209

2020

Abstract: Antipsychotic clozapine is the most effective medication currently available for schizophrenia. However, clozapine is dramatically underutilized due to its harsh side effects that are not effectively monitored. By continuously monitoring clozapine blood ... ...

Abstract	Antipsychotic clozapine is the most effective medication currently available for schizophrenia. However, clozapine is dramatically underutilized due to its harsh side effects that are not effectively monitored. By continuously monitoring clozapine blood levels, such as use of an implantable glucometer, which has transformed diabetes management, the treatment can be optimized and side effects will be minimized. Currently, none of the methods for clozapine detection show the ability to repeatedly measure clozapine in whole blood without pretreatment steps. Here we propose using a microelectrode modified with reduced graphene oxide—a material that was used for repeatable measurements in implantable electrochemical devices. We present the successful direct electrodeposition of reduced-graphene oxide coating onto microelectrodes. Systematic characterization of the electrodeposition technique parameters (i.e., the technique scan rate and the number of cycles) revealed their effect on the electrochemical activity and the structural properties (the film thickness and roughness) of the films. The developed reduced–graphene oxide-modified microelectrode exhibited the feasibility to detect clozapine in microliters–volume-samples of whole blood with a limit-of-detection and a sensitivity of 0.64 ± 0.04 μM and 19.6 ± 1.3 μA/cm2μM, respectively. Moreover, the reduced graphene oxide-modified microelectrodes exhibited high repeatability (retaining 94.6% of the electrochemical signal after 10 repeats), reproducibility (3.6% relative standard deviation), and storage stability (retaining 89% of the electrochemical signal after 4 weeks). Finally, relative recovery studies of 0.5, 1, and 2 μM clozapine concentrations resulted in 108 ± 4.0%, 112 ± 3.5%, and 103 ± 2.2%, respectively. Future studies should investigate the microelectrode fouling mechanisms in whole blood and explore methods to overcome fouling.
Keywords	adverse effects ; blood ; coatings ; detection limit ; diabetes ; disease control ; drug therapy ; electrochemistry ; electroplating ; fouling ; microelectrodes ; monitoring ; roughness ; schizophrenia ; standard deviation ; storage quality
Language	English
Dates of publication	2020-0301
Publishing place	Elsevier B.V.
Document type	Article
ZDB-ID	1500969-5
ISSN	1873-3573 ; 0039-9140
ISSN (online)	1873-3573
ISSN	0039-9140
DOI	10.1016/j.talanta.2019.120560
Database	NAL-Catalogue (AGRICOLA)

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Book ; Online: Multimodal Approach for Assessing Neuromotor Coordination in Schizophrenia Using Convolutional Neural Networks

Siriwardena, Yashish M. / Kitchen, Chris / Kelly, Deanna L. / Espy-Wilson, Carol

2021

Abstract: This study investigates the speech articulatory coordination in schizophrenia subjects exhibiting strong positive symptoms (e.g. hallucinations and delusions), using two distinct channel-delay correlation methods. We show that the schizophrenic subjects ... ...

Abstract	This study investigates the speech articulatory coordination in schizophrenia subjects exhibiting strong positive symptoms (e.g. hallucinations and delusions), using two distinct channel-delay correlation methods. We show that the schizophrenic subjects with strong positive symptoms and who are markedly ill pose complex articulatory coordination pattern in facial and speech gestures than what is observed in healthy subjects. This distinction in speech coordination pattern is used to train a multimodal convolutional neural network (CNN) which uses video and audio data during speech to distinguish schizophrenic patients with strong positive symptoms from healthy subjects. We also show that the vocal tract variables (TVs) which correspond to place of articulation and glottal source outperform the Mel-frequency Cepstral Coefficients (MFCCs) when fused with Facial Action Units (FAUs) in the proposed multimodal network. For the clinical dataset we collected, our best performing multimodal network improves the mean F1 score for detecting schizophrenia by around 18% with respect to the full vocal tract coordination (FVTC) baseline method implemented with fusing FAUs and MFCCs. Comment: 5 pages. arXiv admin note: text overlap with arXiv:2102.07054
Keywords	Electrical Engineering and Systems Science - Audio and Speech Processing ; Computer Science - Multimedia ; Computer Science - Sound
Subject code	410
Publishing date	2021-10-08
Publishing country	us
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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