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61-649: [REDACTED] Look up ogc in Wiktionary, the free dictionary. OGC may refer to: Oculogyric crisis , a dystonic reaction to certain drugs and/or medical conditions Office of Government Commerce , a department of the government of the United Kingdom O.G.C. (band) , a hip hop group from Brooklyn, New York OGC Nice French association football club based in Nice Open Geospatial Consortium ,

122-585: A documented efficacy when used alone in acute mania/mixed episodes. At least five atypical antipsychotics ( lumateperone , cariprazine , lurasidone , olanzapine , and quetiapine ) have also been found to possess efficacy in the treatment of bipolar depression as a monotherapy, whereas only olanzapine and quetiapine have been proven to be effective broad-spectrum (i.e., against all three types of relapse—manic, mixed and depressive) prophylactic (or maintenance ) treatments in patients with bipolar disorder. A recent Cochrane review also found that olanzapine had

183-552: A favorable effect on long-term outcomes is equivocal. Placebo-controlled trials of both first- and second-generation antipsychotic drugs consistently demonstrate the superiority of active drugs over placebos in suppressing psychotic symptoms. A large meta-analysis of 38 trials of antipsychotic drugs in schizophrenia with acute psychotic episodes showed an effect size of about 0.5. There is little or no difference in efficacy among approved antipsychotic drugs, including both first- and second-generation agents. The efficacy of such drugs

244-455: A first episode of psychosis will later be diagnosed with schizophrenia. The conversion rate for a first episode of drug induced psychosis to bipolar disorder or schizophrenia is lower, with 30% of people converting to either bipolar disorder or schizophrenia. NICE makes no distinction between substance-induced psychosis and any other form of psychosis. The rate of conversion differs for different classes of drugs. Pharmacological options for

305-469: A first-line treatment for manic and mixed episodes associated with bipolar disorder. The reason for this combination is the therapeutic delay of the aforementioned mood stabilizers (for valproate therapeutic effects are usually seen around five days after treatment is commenced whereas lithium usually takes at least a week before the full therapeutic effects are seen) and the comparatively rapid antimanic effects of antipsychotic drugs. The antipsychotics have

366-459: A fixed stare. Then comes the more characteristically described extreme and sustained upward deviation of the eyes. In addition, the eyes may converge, deviate upward and laterally, or deviate downward. The most frequently reported associated findings are backwards and lateral flexion of the neck, widely opened mouth, tongue protrusion, and ocular pain. However, the condition may also be associated with intensely painful jaw spasms which may result in

427-788: A less favourable risk/benefit ratio than lithium as a maintenance treatment for bipolar disorder. The American Psychiatric Association and the UK National Institute for Health and Care Excellence recommend antipsychotics for managing acute psychotic episodes in schizophrenia or bipolar disorder, and as a longer-term maintenance treatment for reducing the likelihood of further episodes. They state that response to any given antipsychotic can be variable so that trials may be necessary, and that lower doses are to be preferred where possible. A number of studies have looked at levels of "compliance" or "adherence" with antipsychotic regimes and found that discontinuation (stopping taking them) by patients

488-429: A modest benefit compared to placebo in managing aggression or psychosis, but this is combined with a fairly large increase in serious adverse events. Thus, antipsychotics should not be used routinely to treat dementia with aggression or psychosis, but may be an option in a few cases where there is severe distress or risk of physical harm to others. Psychosocial interventions may reduce the need for antipsychotics. In 2005,

549-488: A process called involuntary commitment , in which they can be forced to accept treatment (including antipsychotics). A person can also be committed to treatment outside of a hospital, called outpatient commitment . Antipsychotics in long-acting injectable (LAI), or "depot", form have been suggested as a method of decreasing medication nonadherence (sometimes also called non-compliance). NICE advises LAIs be offered to patients when preventing covert, intentional nonadherence

610-674: A similar mixture of findings and concerns. A survey of children with pervasive developmental disorder found that 16.5% were taking an antipsychotic drug, most commonly for irritability, aggression, and agitation. Both risperidone and aripiprazole have been approved by the US FDA for the treatment of irritability in autistic children and adolescents. A review in the UK found that the use of antipsychotics in England doubled between 2000 and 2019. Children were prescribed antipsychotics for conditions for which there

671-502: A similar rate of extrapyramidal symptoms to haloperidol (typical). A rare but potentially lethal condition of neuroleptic malignant syndrome (NMS) has been associated with the use of antipsychotics. Through its early recognition, and timely intervention rates have declined. However, an awareness of the syndrome is advised to enable intervention. Another less rare condition of tardive dyskinesia can occur due to long-term use of antipsychotics, developing after months or years of use. It

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732-566: A standards organization for geospatial information systems Oregon Graduate Center , a private college in suburban Portland, Oregon Organic Christ Generation , a sect in Switzerland Organically Grown Company (Oregon) , an organic produce wholesale company See also [ edit ] [REDACTED] Search for "ogc" on Misplaced Pages. All pages with titles beginning with OGC All pages with titles containing OGC Topics referred to by

793-412: A steady growth since the introduction of atypical (second-generation) antipsychotics and this is ascribed to off-label use for many other unapproved disorders. Besides the above uses antipsychotics may be used for obsessive–compulsive disorder , post-traumatic stress disorder , personality disorders , Tourette syndrome , autism and agitation in those with dementia. Evidence however does not support

854-415: Is a clinical priority. LAIs are used to ensure adherence in outpatient commitment. A meta-analysis found that LAIs resulted in lower rates of rehospitalization with a hazard ratio of 0.83; however, these results were not statistically significant (the 95% confidence interval was 0.62 to 1.11). Antipsychotics are routinely used, often in conjunction with mood stabilizers such as lithium / valproate , as

915-501: Is an effective treatment for those who respond poorly to other drugs ("treatment-resistant" or "refractory" schizophrenia), but it has the potentially serious side effect of agranulocytosis (lowered white blood cell count) in less than 4% of people. Due to bias in the research the accuracy of comparisons of atypical antipsychotics is a concern. In 2005, a US government body, the National Institute of Mental Health published

976-479: Is associated with higher rates of relapse, including hospitalization. Psychosis and agitation develop in as many as 80 percent of people living in nursing homes. Despite a lack of FDA approval and black-box warnings , atypical antipsychotics are very often prescribed to people with dementia . An assessment for an underlying cause of behavior is needed before prescribing antipsychotic medication for symptoms of dementia . Antipsychotics in old age dementia showed

1037-419: Is clearly superior to placebo in preventing relapse but is associated with weight gain, movement disorders, and high dropout rates. A 3-year trial following persons receiving maintenance therapy after an acute psychotic episode found that 33% obtained long-lasting symptom reduction, 13% achieved remission, and only 27% experienced satisfactory quality of life. The effect of relapse prevention on long term outcomes

1098-484: Is different from Wikidata All article disambiguation pages All disambiguation pages Oculogyric crisis For clarification, oculogyric seizures , also termed versive seizures, represent one of the manifestations of epilepsy . These seizures exhibit the same upward eye movement observed in OGC but are classified as a specific subtype of epilepsy. Initial symptoms include restlessness, agitation, malaise, or

1159-700: Is dose-dependent. The findings advised the consideration of using a prevention therapy for venous thromboembolism after starting treatment with clozapine, and continuing this for six months. Constipation is three times more likely to occur with the use of clozapine, and severe cases can lead to ileus and bowel ischemia resulting in many fatalities. Very rare clozapine adverse effects include periorbital edema due to several possible mechanisms (e.g., inhibition of platelet-derived growth factor receptors leading to increased vascular permeability, antagonism of renal dopamine receptors with electrolyte and fluid imbalance and immune-mediated hypersensitivity reactions). However,

1220-414: Is largely clinical and involves taking a focused history and physical examination to identify possible triggers for the crisis and rule out other causes of abnormal ocular movements. Immediate treatment of drug-induced OGC can be achieved with intravenous antimuscarinics , such as benzatropine or procyclidine . Any causative new medication should be discontinued. The condition may also be treated with

1281-472: Is mixed evidence to support a significant impact of antipsychotic use on primary negative symptoms (such as apathy, lack of emotional affect, and lack of interest in social interactions) or on cognitive symptoms (memory impairments, reduced ability to plan and execute tasks). In general, the efficacy of antipsychotic treatment in reducing positive symptoms appears to increase with the severity of baseline symptoms. All antipsychotic medications work relatively

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1342-667: Is more often reported with use of typical antipsychotics. Very rarely antipsychotics may cause tardive psychosis . Clozapine is associated with side effects that include weight gain, tiredness, and hypersalivation. More serious adverse effects include seizures , NMS, neutropenia , and agranulocytosis (lowered white blood cell count) and its use needs careful monitoring. Clozapine is also associated with thromboembolism (including pulmonary embolism ), myocarditis , and cardiomyopathy . A systematic review of clozapine-associated pulmonary embolism indicates that this adverse effect can often be fatal, and that it has an early onset, and

1403-577: Is no approval, such as autism. Aggressive challenging behavior in adults with intellectual disability is often treated with antipsychotic drugs despite lack of an evidence base. A recent randomized controlled trial , however, found no benefit over placebo and recommended that the use of antipsychotics in this way should no longer be regarded as an acceptable routine treatment. Antipsychotics may be an option, together with stimulants, in people with ADHD and aggressive behavior when other treatments have not worked. They have not been found to be useful for

1464-457: Is similar for those on the autism spectrum . Much of the evidence for the off-label use of antipsychotics (for example, for dementia, OCD, PTSD, personality disorders, Tourette's) was of insufficient scientific quality to support such use, especially as there was strong evidence of increased risks of stroke, tremors, significant weight gain, sedation, and gastrointestinal problems. A UK review of unlicensed usage in children and adolescents reported

1525-602: Is suboptimal. Few patients achieve complete resolution of symptoms. Response rates, calculated using various cutoff values for symptom reduction, are low, and their interpretation is complicated by high placebo response rates and selective publication of clinical trial results. The majority of patients treated with an antipsychotic drug will experience a response within four weeks. The goals of continuing treatment are to maintain suppression of symptoms, prevent relapse, improve quality of life, and support engagement in psychosocial therapy. Maintenance therapy with antipsychotic drugs

1586-510: Is the first time that psychotic symptoms are presented. NICE recommends that all people presenting with first-episode psychosis be treated with both an antipsychotic drug and cognitive behavioral therapy (CBT). NICE further recommends that those expressing a preference for CBT alone be informed that combination treatment is more effective. A diagnosis of schizophrenia is not made at this time as it takes longer to be determined by both DSM-5 and ICD-11 , and only around 60% of those presenting with

1647-471: Is uncertain, as historical studies show little difference in long term outcomes before and after the introduction of antipsychotic drugs. While maintenance therapy clearly reduces the rate of relapses requiring hospitalization, a large observational study in Finland found that, in people that eventually discontinued antipsychotics, the risk of being hospitalized again for a mental health problem or dying increased

1708-580: Is used to treat generalized anxiety disorder . Antipsychotic drug treatment is a key component of schizophrenia treatment recommendations by the National Institute of Health and Care Excellence (NICE), the American Psychiatric Association , and the British Society for Psychopharmacology. The main aim of treatment with antipsychotics is to reduce the positive symptoms of psychosis, that include delusions and hallucinations. There

1769-542: The Food and Drug Administration (FDA) labelling for this indication. There is, however, a greater risk of side effects with their use compared to using traditional antidepressants. The greater risk of serious side effects with antipsychotics is why, e.g., quetiapine was denied approval as monotherapy for major depressive disorder or generalized anxiety disorder, and instead was only approved as an adjunctive treatment in combination with traditional antidepressants. A recent study on

1830-401: The antihistamine diphenhydramine . Neuroleptic Antipsychotics , previously known as neuroleptics and major tranquilizers , are a class of psychotropic medication primarily used to manage psychosis (including delusions , hallucinations , paranoia or disordered thought ), principally in schizophrenia but also in a range of other psychotic disorders. They are also

1891-561: The "high-risk" group; they are considered to have a 20–40% risk of progression to frank psychosis within two years. These patients are often treated with low doses of antipsychotic drugs with the goal of reducing their symptoms and preventing progression to frank psychosis. While generally useful for reducing symptoms, clinical trials to date show little evidence that early use of antipsychotics improves long-term outcomes in those with prodromal symptoms, either alone or in combination with cognitive-behavioral therapy. First-episode psychosis (FEP)

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1952-415: The 1950s, and others were developed until the early 1970s. Second-generation antipsychotics, known as atypical antipsychotics , arrived with the introduction of clozapine in the early 1970s followed by others (e.g., risperidone ). Both generations of medication block receptors in the brain for dopamine , but atypicals block serotonin receptors as well. Third-generation antipsychotics were introduced in

2013-409: The 2000s and offer partial agonism, rather than blockade, of dopamine receptors. Neuroleptic , originating from Ancient Greek : νεῦρον ( neuron ) and λαμβάνω ( take hold of )—thus meaning "which takes the nerve" —refers to both common neurological effects and side effects. Antipsychotics are most frequently used for the following conditions: Given the limited options available to treat

2074-518: The FDA issued an advisory warning of an increased risk of death when atypical antipsychotics are used in dementia. In the subsequent 5 years, the use of atypical antipsychotics to treat dementia decreased by nearly 50%. A number of atypical antipsychotics have some benefits when used in addition to other treatments in major depressive disorder . Aripiprazole, quetiapine extended-release, and olanzapine (when used in conjunction with fluoxetine ) have received

2135-550: The acute presentation, oculogyric crisis can develop as a recurrent syndrome, triggered by stress and by exposure to the drugs mentioned below. Drugs that can trigger an oculogyric crisis include neuroleptics (such as haloperidol , chlorpromazine , fluphenazine , olanzapine ), carbamazepine , chloroquine , cisplatin , diazoxide , levodopa , lithium , metoclopramide , lurasidone , domperidone , nifedipine , pemoline , phencyclidine ("PCP") , reserpine , and cetirizine , an antihistamine. High-potency neuroleptics are

2196-500: The atypical agents (8% vs. 2% to 4%). This is significant because any patient with tardive dyskinesia was specifically excluded from randomization to perphenazine; i.e., in the CATIE study the patient cohort randomized to receive perphenazne was at lower risk of having extrapyramidal symptoms. Atypical antipsychotics do not appear to lead to improved rates of medication adherence compared to typical antipsychotics. Many researchers question

2257-646: The behavioral problems associated with dementia , other pharmacological and non-pharmacological interventions are usually attempted before using antipsychotics. A risk-to-benefit analysis is performed to weigh the risk of the adverse effects of antipsychotics versus: the potential benefit, the adverse effects of alternative interventions, and the risk of failing to intervene when a patient's behavior becomes unsafe. The same can be said for insomnia , in which they are not recommended as first-line therapy. There are evidence-based indications for using antipsychotics in children (e.g., tic disorder, bipolar disorder, psychosis), but

2318-565: The breaking of a tooth. A wave of exhaustion may follow an episode. The abrupt termination of the psychiatric symptoms at the conclusion of the crisis is most striking. Other features that are noted during attacks include mutism , palilalia , eye blinking, lacrimation , pupil dilation , drooling, respiratory dyskinesia , increased blood pressure and heart rate, facial flushing, headache, vertigo, anxiety, agitation, compulsive thinking, paranoia, depression, recurrent fixed ideas, depersonalization, violence, and obscene language. In addition to

2379-436: The effects of serotonergic psychedelics like psilocybin and lysergic acid diethylamide (LSD). Generally, more than one antipsychotic drug should not be used at a time because of increased adverse effects. Some atypicals are associated with considerable weight gain, diabetes and the risk of metabolic syndrome . Unwanted side effects cause people to stop treatment, resulting in relapses. Risperidone (atypical) has

2440-435: The effects of antipsychotic treatment on grey matter volume and the brain's structure have reached conflicting conclusions. A 2012 meta-analysis concluded that grey matter loss is greater in patients treated with first generation antipsychotics relative to those treated with atypicals, and hypothesized a protective effect of atypicals as one possible explanation. A second meta-analysis suggested that treatment with antipsychotics

2501-414: The first-line prescribing of atypicals over typicals, and some even question the distinction between the two classes. In contrast, other researchers point to the significantly higher risk of tardive dyskinesia and other extrapyramidal symptoms with the typicals and for this reason alone recommend first-line treatment with the atypicals, notwithstanding a greater propensity for metabolic adverse effects in

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2562-587: The lack of evidence supporting the benefit of antipsychotics in people with personality disorders, 1 in 4 who do not have a serious mental illness are prescribed them in UK primary care . Many people receive these medication for over a year, contrary to NICE guidelines. In children they may be used in those with disruptive behavior disorders , mood disorders and pervasive developmental disorders or intellectual disability . Antipsychotics are only weakly recommended for Tourette syndrome, because although they are effective, side effects are common. The situation

2623-500: The latter. The UK government organization NICE recently revised its recommendation favoring atypicals, to advise that the choice should be an individual one based on the particular profiles of the individual drug and on the patient's preferences. The re-evaluation of the evidence has not necessarily slowed the bias toward prescribing the atypicals. Antipsychotics, such as risperidone , quetiapine , and olanzapine , have been used as hallucinogen antidotes or "trip killers" to block

2684-464: The longer they were dispensed (and presumably took) antipsychotics prior to stopping therapy. If people did not stop taking antipsychotics, they remained at low risk for relapse and hospitalization compared to those that did. The authors speculated that the difference may be because the people that discontinued treatment after a longer time had more severe mental illness than those that discontinued antipsychotic therapy sooner. A significant challenge in

2745-445: The low doses used, such as dyslipidemia and neutropenia , and a recent network meta-analysis of 154 double-blind, randomized controlled trials of drug therapies vs. placebo for insomnia in adults found that quetiapine did not demonstrated any short-term benefits in sleep quality. Low dose antipsychotics may also be used in treatment of impulse-behavioural and cognitive-perceptual symptoms of borderline personality disorder . Despite

2806-997: The mainstay, together with mood stabilizers , in the treatment of bipolar disorder . Moreover, they are also used as adjuncts in the treatment of treatment-resistant major depressive disorder. Use of any antipsychotic is associated with reductions in brain tissue volumes, including white matter reduction, an effect which is dose-dependent and time-dependent. A recent controlled trial suggests that second generation antipsychotics combined with intensive psychosocial therapy may potentially prevent pallidal brain volume loss in first episode psychosis. The use of antipsychotics may result in many unwanted side effects such as involuntary movement disorders , gynecomastia , impotence , weight gain and metabolic syndrome . Long-term use can produce adverse effects such as tardive dyskinesia , tardive dystonia , and tardive akathisia. First-generation antipsychotics (e.g., chlorpromazine ), known as typical antipsychotics , were first introduced in

2867-435: The most common cause. Other causes can include aromatic L -amino acid decarboxylase deficiency , postencephalitic Parkinson's , Tourette's syndrome , multiple sclerosis , neurosyphilis , head trauma , bilateral thalamic infarction , lesions of the fourth ventricle , cystic glioma of the third ventricle , herpes encephalitis , kernicterus and juvenile Parkinson's disease. The diagnosis of oculogyric crisis

2928-550: The prevention of delirium among those admitted to hospital. Aside from reduced extrapyramidal symptoms, and with the clear exception of clozapine, it is unclear whether the atypical (second-generation) antipsychotics offer advantages over older, first generation antipsychotics. Amisulpride , olanzapine , risperidone and clozapine may be more effective but are associated with greater side effects. Typical antipsychotics have equal drop-out and symptom relapse rates to atypicals when used at low to moderate dosages. Clozapine

2989-406: The results of a major independent study (the CATIE project). No other atypical studied ( risperidone , quetiapine , and ziprasidone ) did better than the first-generation antipsychotic perphenazine on the measures used, nor did they produce fewer adverse effects than the typical antipsychotic perphenazine, although more patients discontinued perphenazine owing to extrapyramidal effects compared to

3050-682: The risk of serious adverse effects from clozapine is low, and there are the beneficial effects to be gained of a reduced risk of suicide, and aggression. Typical antipsychotics and atypical risperidone can have a side effect of sexual dysfunction. Clozapine, olanzapine, and quetiapine are associated with beneficial effects on sexual functioning helped by various psychotherapies. Common (≥ 1% and up to 50% incidence for most antipsychotic drugs) adverse effects of antipsychotics include: Rare/Uncommon (<1% incidence for most antipsychotic drugs) adverse effects of antipsychotics include: Some studies have found decreased life expectancy associated with

3111-403: The same term [REDACTED] This disambiguation page lists articles associated with the title OGC . If an internal link led you here, you may wish to change the link to point directly to the intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=OGC&oldid=1073411707 " Category : Disambiguation pages Hidden categories: Short description

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3172-434: The same way: by antagonizing D2 dopamine receptors. However, there are some differences when it comes to typical and atypical antipsychotics. For example, atypical antipsychotic medications have been seen to lower the neurocognitive impairment associated with schizophrenia more than conventional antipsychotics, although the reasoning and mechanics of this are still unclear to researchers. Applications of antipsychotic drugs in

3233-430: The specific treatment of FEP have been discussed in recent reviews. The goals of treatment for FEP include reducing symptoms and potentially improving long-term treatment outcomes. Randomized clinical trials have provided evidence for the efficacy of antipsychotic drugs in achieving the former goal, with first-generation and second generation antipsychotics showing about equal efficacy. The evidence that early treatment has

3294-771: The treatment of schizophrenia include prophylaxis for those showing symptoms that suggest that they are at high risk of developing psychosis; treatment of first-episode psychosis; maintenance therapy (a form of prophylaxis, maintenance therapy aims to maintain therapeutic benefit and prevent symptom relapse); and treatment of recurrent episodes of acute psychosis. Test batteries such as the PACE (Personal Assessment and Crisis Evaluation Clinic) and COPS (Criteria of Prodromal Syndromes), which measure low-level psychotic symptoms and cognitive disturbances, are used to evaluate people with early, low-level symptoms of psychosis. Test results are combined with family history information to identify patients in

3355-506: The use of antipsychotic drugs for the prevention of relapse is the poor rate of adherence. In spite of the relatively high rates of adverse effects associated with these drugs, some evidence, including higher dropout rates in placebo arms compared to treatment arms in randomized clinical trials, suggests that most patients who discontinue treatment do so because of suboptimal efficacy. If someone experiences psychotic symptoms due to nonadherence, they may be compelled to receive treatment through

3416-408: The use of antipsychotics outside of those contexts (e.g., to treat behavioral problems) warrants significant caution. Antipsychotics are used to treat tics associated with Tourette syndrome . Aripiprazole , an atypical antipsychotic , is used as add-on medication to ameliorate sexual dysfunction as a symptom of selective serotonin reuptake inhibitor (SSRI) antidepressants in women. Quetiapine

3477-465: The use of antipsychotics, and argued that more studies are needed. Antipsychotics may also increase the risk of early death in individuals with dementia . Antipsychotics typically worsen symptoms in people with depersonalisation disorder. Antipsychotic polypharmacy (prescribing two or more antipsychotics at the same time for an individual) is a common practice but not evidence-based or recommended, and there are initiatives to curtail it. Similarly,

3538-443: The use of antipychotics in unipolar depression concluded that the use of those drugs in addition to antidepressants alone leads to a worse disease outcome. This effect is especially pronounced in younger patients with psychotic unipolar depression. Considering the wide use of such combination therapies, further studies on the side effects of antipychotics as an add-on therapy are warranted. Global antipsychotic utilization has seen

3599-409: The use of atypical antipsychotics in eating disorders or personality disorder. The atypical antipsychotic risperidone may be useful for obsessive–compulsive disorder . The use of low doses of antipsychotics for insomnia , while common, is not recommended as there is little evidence of benefit as well as concern regarding adverse effects. Some of the more serious adverse effects may also occur at

3660-496: The use of excessively high doses (often the result of polypharmacy) continues despite clinical guidelines and evidence indicating that it is usually no more effective but is usually more harmful. A meta-analysis of observational studies with over two million individuals has suggested a moderate association of antipsychotic use with breast cancer. Loss of grey matter and other brain structural changes over time are observed amongst people diagnosed with schizophrenia. Meta-analyses of

3721-651: Was associated with increased grey matter loss. Animal studies found that monkeys exposed to both first- and second-generation antipsychotics experience significant reduction in brain volume, resulting in an 8-11% reduction in brain volume over a 17–27 month period. The National Association of State Mental Health Program Directors said that antipsychotics are not interchangeable and it is recommend including trying at least one weight-neutral treatment for those patients with potential metabolic issues. Subtle, long-lasting forms of akathisia are often overlooked or confused with post-psychotic depression, in particular when they lack

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