Discontinuation Rate of Lurasidone and Quetiapine Extended Release in Bipolar Depression.

INTRODUCTION: Lurasidone (LUR) was compared with quetiapine extended release (QUE-ER) regarding 1-year discontinuation in patients with bipolar depression (n=317). METHODS: This is a retrospective cohort study. RESULTS: Although the time to all-cause discontinuation was estimated using the Kaplan-Meier survival curve with log-rank tests to compare treatment groups, no difference was found (p=0.317). The Cox proportional hazard model revealed that only the presence of adverse events (AEs) is associated with increased treatment discontinuation (p<0.0001). The most common AEs were akathisia for LUR (17.7%) and somnolence for QUE-ER (34.7%). In other Cox models divided by LUR or QUE-ER, the presence of akathisia or somnolence was associated with increased LUR (p=0.0205) or QUE-ER (p<0.0001) discontinuation, respectively. DISCUSSION: The acceptability of both antipsychotics to bipolar depression in clinical practice may be similar. However, specific AEs for each antipsychotic (LUR: akathisia and QUE-ER: somnolence) were associated with high treatment discontinuation.

Serotonin 3 receptor antagonists for obsessive-compulsive disorder: A systematic review and pairwise meta-analysis.

The benefits of serotonin 3 receptor antagonists (5-HT3R-As) in obsessive-compulsive disorder (OCD) treatment remain unclear. Thus, this study aimed to perform a systematic review and a random-effects meta-analysis, including double-blind, randomized, placebo-controlled trials (DBRPCTs). The outcomes include the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) total score (primary), Y-BOCS obsession subscale score, Y-BOCS compulsive subscale score, treatment response, remission rate, all-cause discontinuation, and incidence of individual adverse events (nervousness/restlessness/anxiety, insomnia, headache, dizziness/lightheadedness, decreased appetite, constipation, nausea/vomiting, diarrhea, dry mouth, sweating/increased perspiration, itching/pruritus, tremor, and sexual dysfunction/decreased libido). The mean differences (MD) for continuous outcomes and risk ratios for dichotomous outcomes with 95% confidence intervals (CIs) were calculated. Our study included 10 DBRPCTs (n = 628). Pooled 5-HT3R-As outperformed placebo regarding Y-BOCS total score (MD = -5.08, 95% CI = -7.04, -3.12, N = 9, n = 560), Y-BOCS obsession subscale score, Y-BOCS compulsive subscale score, treatment response, and remission rate. Individually, all 5-HT3R-As outperformed placebo regarding Y-BOCS total score (granisetron: MD = -5.59, 95% CI = -8.79, -2.39, N = 3, n = 178, ondansetron: MD = -5.72, 95% CI = -8.06, -3.37, N = 6, n = 331, tropisetron: MD = -2.87, 95% CI = -5.19, -0.550, N = 1, n = 96). However, all-cause discontinuation and incidence of individual adverse events between pooled 5-HT3R-As and placebo were not significantly different. In conclusion, our meta-analysis suggested 5-HT3R-As as efficacious for symptom improvement in individuals with OCD. However, the number of individuals included in each study was small; thus, a replication randomized trial of 5-HT3R-As should be conducted using a larger sample size.

In operando X-ray absorption fine structure studies of polyoxometalate molecular cluster batteries: polyoxometalates as electron sponges.

We carried out in operando Mo K-edge X-ray absorption fine structure measurements on the rechargeable molecular cluster batteries (MCBs) of polyoxometalates (POMs), in which a Keggin-type POM, [PMo(12)O(40)](3-), is utilized as a cathode active material with a lithium metal anode. The POM-MCBs exhibit a large capacity of ca. 270 (A h)/kg in a voltage range between V = 4.0 V and V = 1.5 V. X-ray absorption near-edge structure analyses demonstrate that all 12 Mo(6+) ions in [PMo(12)O(40)](3-) are reduced to Mo(4+) in the discharging process. This means the formation of a super-reduced state of the POM, namely, [PMo(12)O(40)](27-), which stores 24 electrons, and this electron number can explain the large capacity of the POM-MCBs. Furthermore, extended X-ray absorption fine structure analyses reveal the molecular structure of [PMo(12)O(40)](27-), which is slightly reduced in size compared to the original [PMo(12)O(40)](3-) and involves Mo(4+) metal-metal-bonded triangles. Density functional theory calculations suggest that these triangles are formed because of the large number of additional electrons in the super-reduced state.

In-situ XAFS studies of Mn12 molecular-cluster batteries: super-reduced Mn12 clusters in solid-state electrochemistry.

In situ X-ray absorption fine structure (XAFS) analyses were performed on rechargeable molecular cluster batteries (MCBs), which were formed by a lithium anode and cathode-active material, [Mn(12)O(12)(CH(3)CH(2)C(CH(3))(2)COO)(16)(H(2)O)(4)] with tert-pentyl carboxylate ligand (abbreviated as Mn12tPe), and with eight Mn(3+) and four Mn(4+) centers. This mixed valence cluster compound is used in an effort to develop a reusable in situ battery cell that is suitable for such long-term performance tests. The Mn12tPe MCBs exhibit a large capacity of approximately 210 Ah kg(-1) in the voltage range V=4.0-2.0 V. The X-ray absorption near-edge structure (XANES) spectra exhibit a systematic change during the charging/discharging with an isosbestic point at 6555 eV, which strongly suggests that only either the Mn(3+) or Mn(4+) ions in the Mn12 skeleton are involved in this battery reaction. The averaged manganese valence, determined from the absorption-edge energy, decreased monotonically from 3.3 to 2.5 in the first half of the discharging (4.0>V>2.8 V), but changed little in the second half (2.8>V>2.0 V). The former valence change indicates a reduction of the initial [Mn12](0) state by approximately ten electrons, which corresponds well with the half value of the observed capacity. Therefore, the large capacity of the Mn12 MCBs can be understood as being due to a combination of the redox change of the manganese ions and presumably a capacitance effect. The extended X-ray absorption fine structure (EXAFS) indicates a gradual increase of the Mn(2+) sites in the first half of the discharging, which is consistent with the XANES spectra. It can be concluded that the Mn12tPe MCBs would include a solid-state electrochemical reaction, mainly between the neutral state [Mn12](0) and the super-reduced state [Mn12](8-) that is obtained by a local reduction of the eight Mn(3+) ions in Mn12 toward Mn(2+) ions.

Rechargeable batteries driven by redox reactions of Mn12 clusters with structural changes: XAFS analyses of the charging/discharging processes in molecular cluster batteries.

Molecular clusters such as the Mn12 cluster (Mn12) can be used as a cathode-active material in Li batteries. X-ray absorption fine structure studies on the cathode materials in Mn12 molecular cluster batteries demonstrated that the charging/discharging processes include four-electron-redox reaction of Mn12 with a significant change in its molecular structure.