An update on the efficacy and safety of iloperidone as a schizophrenia therapy.

INTRODUCTION: Schizophrenia has a prevalence of approximately 1% in the general population, with 15.2 per 100,000 persons affected. Iloperidone is a second-generation antipsychotic drug approved for the treatment of schizophrenia in adults. It acts primarily by D2/5HT2a receptor antagonism, with greater affinity for the 5HT2a receptor than for the D2 receptor. AREAS COVERED: This article discusses iloperidone and aims to provide useful information for clinicians to determine which circumstances would best suit the use of iloperidone to treat schizophrenic patients. In this review, the authors briefly discuss schizophrenia and its treatment, before they discuss properties of iloperidone, its indications, approval process, and adverse effects. Finally, the authors review the specific strengths and weaknesses of the medication. EXPERT OPINION: Iloperidone would be an attractive option in patients who are particularly prone to EPS, or who are showing prominent negative symptoms, as well as cognitive deficits. Its availability only in an oral formulation makes it a better option for patients with good medication adherence, and though it could be useful in patients prone to weight gain or hepatic dysfunction on other second generation antipsychotics, it should be used with caution in patients prone to side effects related to alpha adrenergic blockade.

Bestiality Among Sexually Violent Predators.

Bestiality, or sexual contact between humans and nonhuman animals, is a poorly understood aspect of sexual behavior. There is a dearth of scientific research on the prevalence of bestiality, the motivations for individuals to engage in the behavior, and the risk that such individuals pose for interpersonal sexual and nonsexual violence. This study is a descriptive analysis of bestiality in all individuals found to be sexually violent predators (SVPs) in the state of Virginia between the years 2003 and 2017. Of 1,248 SVPs, 33 (2.6%) had a history of engaging in bestiality. SVPs with a history of bestiality were significantly more likely to be victims of childhood sexual abuse (P < .005), to engage in nonsexual animal abuse (P < .0001), and to have committed child sexual abuse (P < .005). They were most likely to report sexual contact with dogs and demonstrated a breadth of other atypical sexual behavior. The lifetime prevalence of 2.6 percent is low compared with other published findings, suggesting that offenders may have intentionally minimized their history of atypical sexual behavior. The relationship between childhood sexual victimization and bestiality has not previously been reported in the literature and represents an important nidus for future investigation. Further research is necessary to characterize human-animal sexual interactions in SVPs and other populations.