Emerging treatments in the management of schizophrenia – focus on sertindole

The antipsychotic treatment of schizophrenia is still marked by poor compliance, and drug discontinuation; the development of more effective and safer drugs still remains a challenge. Sertindole is a second-generation antipsychotic with high affinity for dopamine D2, serotonin 5-HT2A, 5-HT2C, and α1-adrenergic receptors, and low affinity for other receptors. Sertindole undergoes extensive hepatic metabolism by the cytochrome P450 isoenzymes CYP2D6 and CYP3A4 and has an elimination half-life of approximately three days. In controlled clinical trials sertindole was more effective than placebo in reducing positive and negative symptoms, whereas it was as effective as haloperidol and risperidone against the positive symptoms of schizophrenia. The effective dose-range of sertindole is 12–20 mg, administered orally once daily. The most common adverse events are headhache, insomnia, rhinitis/nasal congestion, male sexual dysfunction, and moderate weight gain, with few extrapyramidal symptoms and metabolic changes. Sertindole is associated with corrected QT interval prolongation, with subsequent risk of serious arrythmias. Due to cardiovascular safety concerns, sertindole is available as a second-line choice for patients intolerant to at least one other antipsychotic agent. Further clinical studies, mainly direct “head-to-head” comparisons with other second-generation antipsychotic agents, are needed to define the role of sertindole in the treatment of schizophrenia

Dental anxiety, psychiatry and dental treatment: How are they linked?

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Ansiedad dental en relación a las características agresivas de pacientes

Dental anxiety is defined as the response to a stressful stimulus that is specific to a dental context. The dental treatment itself may provoke excitation and aggressive response relating to multiple sources of motivation that have been examined by the literature.The hypothesis to test in the present paper is to what extent dental anxiety can be explained by looking at patients’ characteristics solely or by considering latent aggressiveness that could be manifested before and during the dental treatment.The results of the study should give some indications to dentists to better understand the presence of a greater or lesser anxiety associated with orthodontic treatment in order to provide an appropriate assistance and, eventually, to help patients in developing coping strategies. As a consequence, it should be clear how intervening on each component of dental anxiety and/or aggressiveness may have a positive impact on the outcome of dental treatment.La ansiedad dental es definida como la respuesta a un estímulo estresante que puede pertenecer a un contexto dental. El tratamiento dental puede provocar excitación y respuestas agresivas relacionadas a múltiples fuentes de motivación que han sido examinadas por la literatura.La hipótesis a evaluar en el presente texto consiste en hasta que alcance la ansiedad dental puede ser explicada al observar solamente características del paciente o al considerar agresividad latente que podría ser manifestada antes y durante el tratamiento dental.Los resultados de este estudio deberían dar algunas indicaciones a los dentistas para entender mejor la presencia de una mayor o menor ansiedad asociada a  tratamientos ortodónticos para generar una asistencia apropiada y, eventualmente, para ayudar a los pacientes a desarrollar estrategias para superar tales dificultades. Como consecuencia, debería estar claro como intervenir en cada componente de la ansiedad dental y/o agresividad podría tener un impacto positivo en el resultado de un tratamiento dental

Dental anxiety in relation to aggressive characteristics of patients

to a dental context. The dental treatment itself may provoke excitation and aggressive response relating to multiple sources of motivation that have been examined by the literature. The hypothesis to test in the present paper is to what extent dental anxiety can be explained by looking at patients’ characteristics solely or by considering latent aggressiveness that could be manifested before and during the dental treatment. The results of the study should give some indications to dentists to better understand the presence of a greater or lesser anxiety associated with orthodontic treatment in order to provide an appropriate assistance and, eventually, to help patients in developing coping strategies. As a consequence, it should be clear how intervening on each component of dental anxiety and/or aggressiveness may have a positive impact on the outcome of dental treatment

Dental anxiety in relation to aggressive characteristics of patients

Dental anxiety is defined as the response to a stressful stimulus that is specific to a dental context. The dental treatment itself may provoke excitation and aggressive response relating to multiple sources of motivation that have been examined by the literature.The hypothesis to test in the present paper is to what extent dental anxiety can be explained by looking at patients’ characteristics solely or by considering latent aggressiveness that could be manifested before and during the dental treatment.The results of the study should give some indications to dentists to better understand the presence of a greater or lesser anxiety associated with orthodontic treatment in order to provide an appropriate assistance and, eventually, to help patients in developing coping strategies. As a consequence, it should be clear how intervening on each component of dental anxiety and/or aggressiveness may have a positive impact on the outcome of dental treatment.La ansiedad dental es definida como la respuesta a un estímulo estresante que puede pertenecer a un contexto dental. El tratamiento dental puede provocar excitación y respuestas agresivas relacionadas a múltiples fuentes de motivación que han sido examinadas por la literatura.La hipótesis a evaluar en el presente texto consiste en hasta que alcance la ansiedad dental puede ser explicada al observar solamente características del paciente o al considerar agresividad latente que podría ser manifestada antes y durante el tratamiento dental.Los resultados de este estudio deberían dar algunas indicaciones a los dentistas para entender mejor la presencia de una mayor o menor ansiedad asociada a  tratamientos ortodónticos para generar una asistencia apropiada y, eventualmente, para ayudar a los pacientes a desarrollar estrategias para superar tales dificultades. Como consecuencia, debería estar claro como intervenir en cada componente de la ansiedad dental y/o agresividad podría tener un impacto positivo en el resultado de un tratamiento dental