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Research in the treatment and causes of schizophrenia

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S'eclairer

Vishwajit L Nimgaonkar, MD, PhD Professor of Psychiatry and Human Genetics, University of Pittsburgh Medicine, Culture, and Spirituality Conference September 9, 2011

Health & Medicine
1 of 32
Research in the treatment and causes of schizophrenia Vishwajit L Nimgaonkar, MD, PhD Professor of Psychiatry and Human Genetics, University of Pittsburgh [email_address]
Disclosure statement ,[object Object],[object Object]
Outline (vignettes) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Outline ,[object Object],[object Object],[object Object],[object Object],[object Object]
Empirical Diagnosis (DSM IV) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Coming soon … ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Outline: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Patient Outcomes Research Team (PORT, Lehman et al, 1995 ….) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Antipsychotic drugs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classical: first generation antipsychotic drugs ,[object Object],[object Object],[object Object],[object Object],[object Object]
Second generation antipsychotic drugs ,[object Object],[object Object],[object Object]
Most recent antipsychotic drugs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
‘ Newest’ antipsychotic drugs* * Cindy Holway, PharmD, MBA Drug Advantages Side effects/concerns Asenapine (Saphris) Sublingual, rapid absorption. Akathisia, oral hypoesthesia, somnolence. ? Hemodynamics. Iloperidone (Fanapt) Low EPS, low akathisia, little weight gain. Dizziness, orthostasis. ? QT prolongation. Lurasidone (Latuda) Pregnancy category B, low weight gain, low extra pyramidal symptoms. Akathisia, nausea. ? Use in moderate / severe renal impairment.
Adjunctive treatments (PORT, Dixon et al, 2010) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
More evidence needed (PORT, Dixon et al, 2010) ,[object Object],[object Object],[object Object],[object Object]
Outline ,[object Object],[object Object],[object Object],[object Object],[object Object]
Genetics: ‘tsunami’ ,[object Object],[object Object],[object Object]
GWAS: HLA variants and schizophrenia
HLA variants in schizophrenia: Pittsburgh studies
Copy number variations in schizophrenia ,[object Object],[object Object],[object Object],[object Object],[object Object]
Antibodies to Toxoplasma gondii in Patients with Schizophrenia: Meta-Analysis ,[object Object],[object Object],[object Object],[object Object]
Outline ,[object Object],[object Object],[object Object],[object Object],[object Object]
Abnormalities in the auditory cortex ,[object Object],[object Object]
Small molecule modulation of dendritic spine structural plasticity to enhance persistence and prevent loss Prevention Auditory Cortex Clinical Feature Pathophysiology Pathology Vocal Emotion Discrimination Pitch Discrimination Pathogenesis Affective Impairment
[object Object],[object Object],[object Object],[object Object],Cognitive remediation: medications
Anti-herpes virus specific treatment and cognition in schizophrenia: a test-of-concept randomized double blind placebo controlled trial K M Prasad MD Assistant Professor of Psychiatry University of Pittsburgh ( unpublished)
Changes in neuropsychological scores with Valacyclovir ‘add on’
Yoga for cognitive remediation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Outline ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],A Family Study of Schizophrenia and Related Conditions
Participation details ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
A Family Study of Schizophrenia and Related Conditions Please visit our table at the conference TOLL FREE: 1-877-363-5895 Fax: (412) 246 6350 WEB SITE: www.pitt.edu/~nimga

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Research in the treatment and causes of schizophrenia

  • 1. Research in the treatment and causes of schizophrenia Vishwajit L Nimgaonkar, MD, PhD Professor of Psychiatry and Human Genetics, University of Pittsburgh [email_address]
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  • 13. ‘ Newest’ antipsychotic drugs* * Cindy Holway, PharmD, MBA Drug Advantages Side effects/concerns Asenapine (Saphris) Sublingual, rapid absorption. Akathisia, oral hypoesthesia, somnolence. ? Hemodynamics. Iloperidone (Fanapt) Low EPS, low akathisia, little weight gain. Dizziness, orthostasis. ? QT prolongation. Lurasidone (Latuda) Pregnancy category B, low weight gain, low extra pyramidal symptoms. Akathisia, nausea. ? Use in moderate / severe renal impairment.
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  • 18. GWAS: HLA variants and schizophrenia
  • 19. HLA variants in schizophrenia: Pittsburgh studies
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  • 24. Small molecule modulation of dendritic spine structural plasticity to enhance persistence and prevent loss Prevention Auditory Cortex Clinical Feature Pathophysiology Pathology Vocal Emotion Discrimination Pitch Discrimination Pathogenesis Affective Impairment
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  • 26. Anti-herpes virus specific treatment and cognition in schizophrenia: a test-of-concept randomized double blind placebo controlled trial K M Prasad MD Assistant Professor of Psychiatry University of Pittsburgh ( unpublished)
  • 27. Changes in neuropsychological scores with Valacyclovir ‘add on’
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  • 32. A Family Study of Schizophrenia and Related Conditions Please visit our table at the conference TOLL FREE: 1-877-363-5895 Fax: (412) 246 6350 WEB SITE: www.pitt.edu/~nimga