Editorial 2/2022

The issue of Pharmacotherapy in Psychiatry and Neurology for the second half-year of 2022 contains one experimental paper, four review papers, and a case report.
The experimental paper is about pharmacotherapy during the intervention of emergency medical teams (EMT) in people with mental disorders, based on two-year observation. Its first author is Łukasz Dudziński from the John Paul II Academy of Applied Sciences in Biała Podlaska. In the two-year period, EMT had 14,972 interventions in the investigated operational area (7,531 in the first year and 7,441 in the second year). The partial target of the analysis (patients with mental disorders) was achieved in 862 events (5.75% of the total). Most EMT interventions requiring the supply of drugs were associated with alcohol abuse and an acute reaction to stress. In 92 EMT interventions for mental disorders, pharmacological agents were administered, a total of 100 drugs, most often hydroxyzine (41%), diazepam (33%), captopril (6%), and multi-electrolyte fluid MEF500 (6%). The COVID-19 pandemic did not significantly affect the frequency of drug administration in EMT interventions.
The aim of the first review paper, authored by Krzysztof Bogusz and Marcin Wojnar from the Department of Psychiatry, Medical University of Warsaw, is to review the current knowledge on brexpiprazole in the treatment of schizophrenia. Brexpiprazole is an antipsychotic drug that exhibits its effects mainly through partial agonism of D2 and D3 dopamine receptors and 5-HT1A serotonin receptors; it also has antagonistic effects against 5-HT2A, 5-HT2B, 5-HT7, histaminic H1, and muscarinic M1 receptors. It is metabolised mainly by CYP3A4 and CYP2D6 enzymes, excreted via the liver and the kidneys, and has a half-life of 96 hours. At doses of 2–4 mg/d, it is effective in treating acute episodes of schizophrenia as it alleviates psychotic symptoms and improves psychosocial functioning. It also shows efficacy in maintenance treatment at doses of 1–4 mg/d, delaying relapse of the illness. It has no effect on metabolic profile, prolactin levels, and QTc interval and a small effect on body weight, and causes a low risk of akathisia.
The second review paper comes from the 2nd Department of Neurology, Institute of Psychiatry and Neurology in Warsaw (Agnieszka Antos et al.) and concerns biomarkers of central nervous system injury in Wilson’s disease (WD). The authors discuss clinical, structural (neuroimaging),...


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