Antipsychotic dosing: found in translation

Antipsychotic dosing: found in translation

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J Psychiatry Neurosci 2014;39(4):223-31

Gary Remington, MD, PhD; Gagan Fervaha, BSc; George Foussias, MD, MSc; Ofer Agid, MD; Peter Turrone, PhD

Remington, Foussias, Agid — Department of Psychiatry, University of Toronto, Toronto, Ont.; Remington, Fervaha, Foussias, Agid, Turrone — Institute of Medical Science, University of Toronto, Toronto, Ont.; Remington, Foussias, Agid — Centre for Addiction and Mental Health (CAMH), Toronto, Ont.; Remington — Campbell Family Mental Health Research Institute, Toronto, Ont., Canada

Abstract

In the field of schizophrenia research, as in other areas of psychiatry, there is a sense of frustration that greater advances have not been made over the years, calling into question existing research strategies. Arguably, many purported gains claimed by research have been “lost in translation,” resulting in limited impact on diagnosis and treatment in the clinical setting. There are exceptions; for example, we would argue that different lines of preclinical and clinical research have substantially altered how we look at antipsychotic dosing. While this story remains a work in progress, advances “found in translation” have played an important role. Detailing these changes, the present paper speaks to a body of evidence that has already shifted clinical practice and raises questions that may further alter the manner in which antipsychotics have been administered over the last 6 decades.


Submitted Sept. 3, 2013; Revised Oct. 16, 2013; Accepted Oct. 23, 2013.

Acknowledgements: This article reflects a talk given by Dr. Remington at the 2012 Canadian College of Neuropsychopharmacology (CCNP) Annual Meeting in Vancouver, British Columbia, in receipt of the 2012 Innovations in Neuropsychopharmacology Award. He expresses his deep appreciation to the CCNP as well as its membership for the award, and also wishes to extend special thanks to Drs. Shitij Kapur and Philip Seeman, who he has collaborated with over the years and whose ideas substantially contribute to this body of work. Each of the present authors is involved in work that is building upon lines of investigation discussed here.

Dr. Remington’s contributions in this area have been supported by the National Alliance for Research on Schizophrenia and Depression (NARSAD), Canadian Institutes of Health Research (CIHR), and Research Hospital Fund–Canada Foundation for Innovation, with additional support for specific projects through individual pharmaceutical companies. In addition, he receives research support through the University of Toronto’s Department of Psychiatry, the Centre for Addiction and Mental Health (CAMH), and the Campbell Family Mental Health Research Institute.

Competing Interests: In the last 3 years, G. Remington has received research support from the Canadian Diabetes Association, the Canadian Institutes of Health Research, Medicure, Neurocrine Biosciences, Novartis Canada, Research Hospital Fund–Canada Foundation for Innovation, and the Schizophrenia Society of Ontario and has served as a consultant or speaker for Novartis, Laboratorios Farmacéuticos Rovi, and Roche. G. Fervaha has been supported through an Ontario Graduate Fellowship. G. Foussias has been involved in research sponsored by Medicure and Neurocrine Bioscience and has served as a consult – ant for Roche. O. Agid has received research support from Pfizer and Janssen-Ortho and has served on advisory boards or speakers bureaus for Janssen-Ortho, Eli Lilly (Canada and U.S.), Novartis, Sepracor, and Sunovion. None declared by P. Turrone.

Contributors: G. Remington provided the framework for the review and wrote the article. All authors contributed to the development of the manuscript, reviewed it and provided final approval for its publication.

DOI: 10.1503/jpn.130191

Correspondence to: G. Remington, Complex Mental Illness Division, Schizophrenia Program, Centre for Addiction and Mental Health, 250 College St., Toronto ON M5T 1R8; gary.remington@camh.ca