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This article's objective is to present the latest evidence and information on the management of postoperative nausea and vomiting (PONV). PONV continues to affect 30% of the surgical population causing patient dissatisfaction, extending length of stay, and increasing overall costs. This review includes the introduction of 2 new intravenous formulations of antiemetics (amisulpride, aprepitant), updates on nontraditional therapies, suggestions for combination prophylaxis, emerging data on rescue treatment, and considerations for special populations and settings. Both of the new antiemetics provide promising options for pharmacologic interventions for PONV with favorable safety profiles. [ABSTRACT FROM AUTHOR]

Postoperative nausea and vomiting (PONV) afflict approximately 30% of patients overall and up to 80% of high-risk patients after surgery. Optimal pharmacological prophylaxis of PONV is challenging as it necessitates the consideration of PONV risk, drug efficacy, and potential adverse effects. Despite significant advances in our understanding of the pathophysiology and risk factors of PONV, its incidence has remained largely unchanged. Newer antiemetics have been introduced that may have improved safety profiles, longer duration of action, and better efficacy. This review aims to summarize the recent developments pertaining to these new agents and their potential application toward the management of PONV. [ABSTRACT FROM AUTHOR]

Highlights • Tardive dyskinesia (TD) is a most disabling side effect of antipsychotics. • We report a case TD in a patient with schizophrenia on treatment with Amisulpride 400 mg. • He showed improvement in TD, after changing over to 100 mg of Clozapine. [ABSTRACT FROM AUTHOR]

Here, we present a retrospective analysis of the last 5 years' data collected in real-life settings as direct evidence to evaluate the optimal therapeutic window of amisulpride (AMI) for psychiatric patients. Retrospective analysis of the therapeutic drug monitoring (TDM) results of AMI in outpatients and inpatients were obtained from the Xi'an Mental Health Center from 2017 to 2021. The interquartile (P 25 –P 75) AMI concentrations ranged 212.20–574.25 ng/mL. The results showed that the proportion of outpatients who received TDM once was significantly higher than that of inpatients who received TDM once (P < 0.001), whereas the reverse was true for those who experienced TDM more than twice (P < 0.001). Higher estimated plasma concentrations were identified in inpatients, female patients, and patients over 59 years of age. Nearly 57.21% of the samples had high concentrations (>320 ng/mL). The optimal therapeutic reference range for AMI may require reconstruction to guide the use of AMI for the treatment of schizophrenia. • The study found that amisulpride concentration has a large interindividual variability in plasma levels, often outside the reference range (100–320 ng/mL). • This study suggested that being female and elderly are contributor to the higher amisulpride concentration. • The study provides direct evidence for future studies to evaluate the optimal therapeutic window of amisulpride for psychiatric patients based on the last 5 years' AMI steady-state plasma concentration data. [ABSTRACT FROM AUTHOR]

Pharmaceutical waste products have become environmental contamination and pollution which poses a significant risk to our planet. The fabrication of effective antipsychotic drug monitoring systems is greatly important to minimize their environmental problems. Therefore, the construction of mixed metal molybdates has been investigated to develop an electrochemical sensor with high sensitivity and low detection limits. In regards, we have successively synthesized nickel molybdate/cobalt molybdate (NiMoO 4 /CoMoO 4 ; NCMO) through a simple co-precipitation method and their electrocatalytic activity of chlorpromazine (CPZ) evaluated. The synthesized NCMO was inspected by diverse physicochemical analyses. From the morphological study, the prepared NCMO nanoflake displays exceptionally rich surface electroactive sites. Furthermore, the electrochemical properties of the developed sensor were investigated through cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), and differential pulse voltammetry (DPV). Accordingly, the NCMO endorses greater electrochemical behavior because of rapid electron transfer, improved electrochemical active surface area, and synergetic effect. The established electrochemical sensor displays a wide linear range and the lowest detection limit, admirable sensitivity, reproducibility, and repeatability. Finally, the real-time application of CPZ was performed in wastewater and human urine samples with reasonable recoveries. [Display omitted] • We propose mixed metal molybdate (NiMoO 4 /CoMoO 4) via a simple co-precipitation method. • NCMO is demonstrated to be a sensitive and selective electrochemical detection of the antipsychotic drug chlorpromazine. • NCMO modified screen-printed carbon electrode has detected wide linear range and nanomolar level. • Real sample analyses validate the practical feasibility of the developed sensor with satisfactory results. [ABSTRACT FROM AUTHOR]

Abstract: In the last decades, the potential association between antidepressants and cancer risk has been increasingly investigated. Fundamental researches, performed on animal models and cell tumoral lines, have highlighted several biological mechanisms possibly supporting this association. Nevertheless, the epidemiological studies investigating the risk of cancer in patients receiving selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) have provided conflicting and inconclusive results. Therefore, the prescription of several antidepressants in oncologic patients still remains a matter of discussion. The aim of this review is to present and discuss available evidence concerning the association between the risk of breast and prostate cancer and the use of antidepressant medications. Thus, consistencies, differences, and contradictions of available data are reported. A special focus is addressed to amisulpiride, a widely prescribed drug still poorly investigated with regard to the risk of cancer occurrence and recurrence. Overall, there is no definitive evidence of increased risk of breast and prostate cancer among patients exposed to SSRIs and TCAs. The association between amisulpiride and cancer risk has been to date scarcely explored and considered in clinical settings. Nevertheless, the hyperprolactinemia frequently resulting from its adoption has been repeatedly associated, to increased cancer risk and poorer prognosis in cancer patients. Thus, the use of amisulpiride among cancer patients should be carefully considered. [Copyright &y& Elsevier]

• This study established a suitable blood level of amisulpride in Chinese psychotic patients. It maybe useful for psychotic patients in other country. This study also suggested that past recommended range 100∼320 ng/mL of amisulpride maybe not suitable. To provide therapeutic window of amisulpride dose and serum concentration. 194 schizophrenics were assessed with PANSS. The concentration of Amisulpride in blood was tested. And relationship with concentration was analyzed. The dose of amisulpride was 100mg∼1200 mg/d(555+/-218), plasma concentration was 20∼1280 ng/mL(349+/-223) and C/D ratio was 0.07∼1.65 (0.63+/-0.34). The correlation of dose and concentration was significantly correlated (r = 0.55; P < 0.05).It was found that concentration(P < 0.001), C/D ratio(r = 0.383, P < 0.001), rather than dose (-0.042,p > 0.05) related to age significantly.It was found no differences in dose(p > 0.05), concentration (p > 0.05) and C/D ratio(p > 0.05) between male and female patients. The change ratio of positive symptom was 10 %∼90 %, negative symptom was 5∼80 %, general symptoms was 5∼90 %, PANSS was 5∼90 %.The correlation between change ratio of positive symptom, general symptom and PANSS and dose, concentration were significant(P < 0.01), but not related with the change ratio of negative symptom(p>0.05).The both dose and concentration of amisulpride were higher significantly in effective group than that in ineffective group according to change ratio of positive symptom, negative symptom, general symptom and PANSS(P < 0.01). The correlation of dose and concentration of amisulpride was significantly correlated. The recommended range 457∼637 ng/mL was suggested as average therapeutic window. [ABSTRACT FROM AUTHOR]

Antipsychotics, including amisulpride (AMI), quetiapine (QUE), aripiprazole (ARI), and olanzapine (OLA), are used to treat mental illnesses associated with psychotic symptoms. The effect of these drugs on c-Fos expression in vasopressinergic (AVP) and oxytocinergic (OXY) neurons was studied in the hypothalamic paraventricular nucleus (PVN) of rats. The presence of c-Fos in AVP and OXY perikarya was investigated in seven PVN cells segregations: the anterior (Ant), dorsal cup (Dc), wing-shaped (Wi), periventricular zone (Pe), circle-shaped core (Co) and shell of core (Sh), and the posterior (pPVN) after an acute treatment with AMI-20 mg/kg, QUE-15 mg/kg, ARI-10 mg/kg, and OLA-5 mg/kg/bw in rats. Ninety min after treatments, the animals were sacrificed by transcardial perfusion with fixative and the PVN area sliced into 35 μm thick coronal sections for immunohistochemistry. The c-Fos was processed by avidin-biotin-peroxidase complex intensified with nickel-enhanced 3,3′-diaminobenzidine tetrahydrochloride. Visualization of AVP- and OXY-synthesizing neurons was achieved by a fluorescent marker Alexa Flour 568. The c-Fos-AVP and c-Fos-OXY colocalizations were evaluated from c-Fos stained sections merged with AVP or OXY ones. AMI, QUE, ARI, and OLA, single administration distinctly increased the c-Fos expression in each of the PVN cells segregations. QUE induced the highest magnitude of activation of AVP and OXY neurons, while OLA and AMI had only moderate effects. Incontestable variabilities detected in c-Fos expression in PVN AVP and OXY neurons extend the knowledge of selected antipsychotics extra-striatal actions and may also be helpful in a presumption of their possible functional impact. [ABSTRACT FROM AUTHOR]