Therapeutic effect of aripiprazole in chronic schizophrenia is accompanied by anti-inflammatory activity. Sobis J, Rykaczewska-Czerwinska M, Swietochowska E, Gorczyca P. Aripiprazole-induced adverse metabolic alterations in polyI: C neurodevelopmental model of schizophrenia in rats. Dopamine controls systemic inflammation through inhibition of NLRP3inflammasome. Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An (1)(1)C-(R)-PK11195 PET Study. Cytokine signature associated with disease severity in chronic fatigue syndrome patients. Washington, DC: The National Academies Press 2015. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness. ![]() Improvements in the quality of life enabled six patients to return to work, and four patients reported improvement of their movement disorder (myoclonic dystonia). Fifty-seven individuals qualitatively rated the episodes of PEM as milder and shorter in duration and 18 individuals reported a complete resolution of PEM with no new episodes. The absence of PEM was recorded as “0.” For responders, the average frequency of PEM was 0.24 occurrences per day (or every 4.2 days) before taking the medication and 0.12 occurrences per day (every 8.3 days) while taking aripiprazole (n = 59, p < 0.001). Post-exertional malaise was recorded as the time interval, in days, between the onset of each PEM the episode, which was converted to occurrence per day, or 1/(time interval between episodes). non-responders was not statistically significant ( p = 0.145) using the test for proportions, suggesting that antidepressant use does not predict or preclude a clinical response to aripiprazole.Īmong the responders, the average fatigue score changed from 5.76 to 2.86 (n = 66, delta = − 2.89, p < 0.001). The difference in antidepressant use between responders vs. Patient records were also evaluated for concurrent use of various classes of antidepressants, including selective serotonin reuptake inhibitors (SSRI), serotonin-norepinephrine reuptake inhibitors (SNRI), serotonin modulators, norepinephrine–dopamine reuptake inhibitors (NDRIs), and tri-cyclic antidepressants. The duration of aripiprazole therapy ranged from less than one month to 17 months (mean 7.8 months). Dosage started at 0.25 mg/day and titrated up or down based on each patient's observations and feedback. The daily oral dose of aripiprazole ranged from 0.2 to 2.0 mg/day (mean 1.1 mg/day). The age range was from 18 to 84 years old (mean 50 years), with a gender distribution of 67% female and 33% male, and the duration of illness was from 1 to 54 years (median 13 years). Medical records were included for individuals evaluated in the clinic at least twice, representing periods before and after the use of the medication. In a retrospective study, we reviewed the medical records of 101 patients who met the criteria for a ME/CFS diagnosis according to three separate case definitions (Fukuda, CCC, and IOM) and who received off-label aripiprazole (Table 1). Other studies using positron emission tomography (PET) show evidence of activated microglia or astrocytes in various regions of the brain in patients with ME/CFS. ![]() Additional evidence includes changes in inflammatory cytokines in both plasma and cerebrospinal fluid correlated with the severity of symptoms. Up to 85% of patients with ME/CFS report symptoms of cognitive impairment also referred to as “brain fog,” which includes difficulty with memory, attention, and information processing. Although the cause of the illness is unknown, a growing body of evidence suggests that ME/CFS involves inflammation of the brain. According to the most recent IOM case definition, the core symptoms of ME/CFS include debilitating fatigue, unrefreshing sleep, post-exertional malaise, and either cognitive dysfunction or orthostatic intolerance. An ME/CFS diagnosis is based solely on symptoms with case definitions made by expert consensus, including the Fukuda (1994), Canadian Consensus Criteria (CCC, 2003), International Consensus Criteria (ICC, 2011), and the Institute of Medicine (IOM, 2015) case criteria. ![]() Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a chronic, debilitating illness of unknown etiology.
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