Selective Serotonine Reuptake Inhibitors (SSRI) Usage during Pregnancy.

Depressive disorders in pregnancy are common and generate concerns regarding their treatment. The effects of untreated maternal depressive symptoms on preterm birth, low birthweight, fetal growth restriction and postnatal complications are well known. When left untreated, depressive disorders continue postpartum and have a big impact on the patients' functioning. Selective serotonine reuptake inhibitors (SSRIs) are the first choice of treatment of depressive disorders. However, there are some concerns which should be adressed. The aim of this systematic review is to explore the SSRI usage in pregnancy. We studied the latest literature in the PubMed databases and recommendations from the guidelines. Decision to treat depression in pregnancy should be taken with careful consideration of many factors. Clinicians should weigh the use of SSRIs during pregnancy against the risk of untreated depressive disorder.

Genetic polymorphisms in dopaminergic system and treatment-resistant schizophrenia.

BACKGROUND: Dopaminergic system plays an important role in antipsychotic response. Functional single nucleotide polymorphisms (SNPs) can change dopamine receptor expression or dopamine disposition and thus influence response to antipsychotic treatment. SUBJECTS AND METHODS: 138 schizophrenia patients were stratified in the treatment-resistant and treatment-responsive group. Control group consisted of 94 healthy blood donors. All subjects were genotyped for the following SNPs: DRD1 (rs4532, rs5326), DRD2 (rs1801028, rs1799732), DRD3 (rs6280) and COMT (rs165815, rs4680). Association between the genotypes and clinical symptoms were tested using ANCOVA with current antipsychotic dose as a confounder. Differences in allele frequencies between treatment-responsive and treatment-resistant schizophrenic patients were assessed using χ(2) tests. RESULTS: No statistically significant associations were observed between any of the investigated genotypes and clinical scores and occurrence of the treatment-resistant schizophrenia. CONCLUSIONS: Genetic variability in dopaminergic system does not have a major role in clinical symptoms and occurrence of treatment-resistant schizophrenia among Slovenian patients.

Genetic variability testing of neurodevelopmental genes in schizophrenic patients.

This study investigated the associations between single nucleotide polymorphisms in the neurodevelopmental Disrupted In Schizophrenia 1 (DISC1 ), neuregulin 1 (NRG1), brain-derived neurotrophic factor (BDNF) and NOTCH4 genes and the clinical symptoms and the occurrence of treatment-resistant schizophrenia in the Slovenian population. We included 138 schizophrenia patients, divided into treatment-responsive and treatment-resistant group and 94 healthy blood donors. All subjects were genotyped for eight polymorphisms (DISC1 rs6675281, DISC1 rs821616, NRG1 rs3735781, NRG1 rs3735782, NRG1 rs10503929, NRG1 rs3924999, BDNF rs6265, NOTCH rs367398) and investigated for associations with clinical variables. NOTCH4 rs367398 AA/AG was significantly associated with worse Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression (CGI) score. NOTCH4 rs367398 was not statistically significantly associated with the occurrence of treatment-resistant schizophrenia after the correction for multiple testing. Our data indicate that NOTCH4 polymorphism can influence clinical symptoms in Slovenian patients with schizophrenia.

Influence of 5-HT1A and 5-HTTLPR genetic variants on the schizophrenia symptoms and occurrence of treatment-resistant schizophrenia.

This study aimed to explore the influence of two genetic polymorphisms of the 5-hydroxytryptamine 1A receptor (5-HT1A) and solute carrier family 6, member 4 (SLC6A4) genes on the clinical symptoms and treatment resistance in Slovenian patients with schizophrenia. A total of 138 patients with schizophrenia were evaluated using the Positive and Negative Syndrome Scale, Brief Psychiatric Rating Scale, Clinical Global Impression, and Global Assessment of Functioning. Based on the selected criteria, 94 patients were included in the treatment-responsive and 44 in the treatment-resistant group. All subjects and 94 controls were genotyped for the 5-HT1A rs6295 and 5-HTTLPR polymorphisms. There were no statistically significant differences in the frequencies of these polymorphisms between the patients with schizophrenia and the control group and between the treatment-resistant and treatment-responsive group of schizophrenia patients. Polymorphisms rs6295 and 5-HTTLPR had an influence on the Global Assessment of Functioning scale score, while 5-HTTLPR also had an influence on the total score of the negative subscale within the Positive and Negative Syndrome Scale. Although we found no effect on progression toward the treatment-resistant schizophrenia, our data suggest that the rs6295 and 5-HTTLPR polymorphisms can influence some clinical symptoms in schizophrenia.

Oxidative stress in schizophrenia patients treated with long-acting haloperidol decanoate.

In this study the role of oxidative stress in schizophrenia was investigated by evaluating the relationship of oxidative stress markers with neurochemistry, psychopathology, and extrapyramidal symptoms. Antioxidant activity of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, and concentrations of malondialdehyde, protein carbonyls, nitrite, nitrate, glutathione, dopamine, noradrenaline, adrenaline, and serotonin were measured in 52 outpatients with DSM-IV diagnosis of schizophrenia treated with haloperidol decanoate. Psychopathology and extrapyramidal symptoms were assessed by positive and negative syndrome scale, global assessment of functioning, abnormal involuntary movement scale, Simpson Angus scale, and Barnes akathisia rating scale. Haloperidol dose was positively correlated with plasma protein carbonyls. Longer duration of illness was associated with decreased levels of glutathione peroxidase. Increased activity of superoxide dismutase was associated with increased levels of catalase, glutathione peroxidase, glutathione reductase and reduced glutathione, and decreased concentration of malondialdehyde, indicating joint action of various antioxidative systems. Increased levels of nitrite and noradrenaline were associated with decreased level of malondialdehyde. Akathisia was greater in patients with decreased catalase activity, indicating involvement of impaired antioxidant defense in developing extrapyramidal symptoms. These results confirm the hypothesis that oxidative stress is involved in pathophysiology of schizophrenia and severity of extrapyramidal symptoms.