Side Effects of molindone: A Synthesis of Findings from 26 Studies

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Original Abstract of the Article

Major Research Findings

Molindone is an antipsychotic medication used to treat mental illnesses such as schizophrenia and bipolar disorder. Several studies have shown the effectiveness and safety of molindone. However, it is known that the use of molindone is associated with some risks of side effects.

For example, 20 shows that the use of molindone can lead to agranulocytosis and liver dysfunction. 5 shows that the use of molindone may increase the risk of hospitalization in the elderly.

6 mentions the risk of weight gain and metabolic abnormalities due to the use of molindone. Furthermore, 2 shows that the use of molindone is associated with a higher risk of weight gain in children and adolescents with schizophrenia.

On the other hand, 17 suggests that the use of molindone may be less likely to cause tardive dyskinesia than traditional antipsychotics.

Reasons for Side Effects

The side effects of molindone are mainly due to its effects on dopamine receptors. Molindone blocks dopamine receptors, which improves the symptoms of schizophrenia. However, dopamine receptors are involved in various functions such as motor control and hormone secretion, so blocking dopamine receptors can affect these functions.

Common Side Effects

Weight Gain

6 reports weight gain associated with the use of molindone. Molindone is considered to have a lower risk of weight gain compared to other antipsychotics, but it is still possible to experience weight gain. The mechanisms by which molindone causes weight gain are thought to include increased appetite and metabolic abnormalities.

Tardive Dyskinesia

Tardive dyskinesia is a movement disorder that can occur with long-term use of antipsychotics. Molindone is thought to have a lower risk of tardive dyskinesia compared to other antipsychotics. However, 20 suggests that the use of molindone may cause tardive dyskinesia.

Agranulocytosis

20 shows that the use of molindone can lead to agranulocytosis. Agranulocytosis is a condition in which the number of white blood cells decreases. White blood cells play an important role in protecting the body from infection. Therefore, if agranulocytosis occurs, the risk of infection increases. The mechanism by which molindone causes agranulocytosis is not yet fully understood.

Liver Dysfunction

20 shows that the use of molindone can lead to liver dysfunction. Liver dysfunction is a condition in which the liver's function deteriorates. The liver is an important organ involved in various metabolisms and detoxification. Therefore, if liver dysfunction occurs, various symptoms may appear. The mechanism by which molindone causes liver dysfunction is not yet fully understood.

Other Side Effects

In addition to the above, the following side effects may occur with the use of molindone:

  • Drowsiness
  • Dizziness
  • Constipation
  • Dry mouth
  • Visual disturbances
  • Lactation
  • Sexual dysfunction

These side effects do not occur in all individuals. Also, the severity of side effects varies from person to person.

Countermeasures for Side Effects

Weight Gain

If weight gain occurs with the use of molindone, measures such as diet therapy and exercise therapy are considered. 6 reports that drugs such as amantadine, orlistat, metformin, nizatidine, and topiramate are being studied as countermeasures for weight gain induced by antipsychotics.

Tardive Dyskinesia

Tardive dyskinesia is a movement disorder that can occur with long-term use of antipsychotics. Prevention of tardive dyskinesia requires appropriate use of antipsychotics. If symptoms of tardive dyskinesia appear, measures such as reducing or discontinuing antipsychotics are considered.

Agranulocytosis

If agranulocytosis occurs with the use of molindone, regular monitoring of the condition through blood tests, etc. is necessary. If agranulocytosis progresses, treatment with antibiotics, etc. may be necessary.

Liver Dysfunction

If liver dysfunction occurs with the use of molindone, regular monitoring of the condition through blood tests, etc. is necessary. If liver dysfunction progresses, treatment such as liver transplantation may be necessary.

Comparison between Studies

Common Points of Studies

Multiple studies have shown that the use of molindone can lead to side effects such as weight gain, tardive dyskinesia, agranulocytosis, and liver dysfunction.

Differences in Studies

The incidence and severity of molindone side effects vary from study to study. This is thought to be due to differences in the age, sex, health status, and dosage of molindone among the study subjects.

Precautions for Real-Life Applications

It is important to understand that the use of molindone is associated with some risks of side effects. When considering the use of molindone, it is important to consult with a physician and carefully consider the risks and benefits of side effects. In addition, during the use of molindone, it is necessary to undergo regular blood tests, etc. to detect side effects at an early stage.

Limitations of Current Research

There is not enough research yet on the side effects of molindone. In particular, research on long-term side effects is insufficient. Furthermore, the factors that affect the incidence and severity of molindone side effects are not yet fully understood.

Future Research Directions

Further research on the side effects of molindone is needed. In particular, research on long-term side effects and factors that affect the incidence and severity of side effects is important. Furthermore, the development of therapeutic methods to reduce the side effects of molindone is also needed.

Conclusion

Molindone is an effective medication for treating mental illnesses such as schizophrenia and bipolar disorder. However, it is important to understand that the use of molindone is associated with risks of side effects such as weight gain, tardive dyskinesia, agranulocytosis, and liver dysfunction. When considering the use of molindone, it is important to consult with a physician and carefully consider the risks and benefits of side effects. In addition, during the use of molindone, it is necessary to undergo regular blood tests, etc. to detect side effects at an early stage.

Literature analysis of 26 papers
Positive Content
17
Neutral Content
4
Negative Content
5
Article Type
1
2
1
7
26
1.

Predictors and Moderators of Antipsychotic-Related Weight Gain in the Treatment of Early-Onset Schizophrenia Spectrum Disorders Study.

Author: TaylorJerome H, JakubovskiEwgeni, GabrielDaniel, BlochMichael H

Antipsychotic weight gain

Antipsychotic choice is extremely important for predicting future weight gain. We found that younger age did not predict greater weight gain.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

2.

Efficacy, acceptability, and tolerability of antipsychotics in children and adolescents with schizophrenia: A network meta-analysis.

Author: KrauseMarc, ZhuYikang, HuhnMaximilian, Schneider-ThomaJohannes, BighelliIrene, ChaimaniAnna, LeuchtStefan

Improved schizophrenia symptoms
Prolactin increase
Sedation
Weight gain

This network-meta-analysis of 28 randomized controlled trials (RCTs) involving 3003 participants with schizophrenia found that clozapine was significantly more effective than other antipsychotics, while ziprasidone showed no efficacy. Most antipsychotics were more effective than placebo, but there were evidence gaps for some drugs and outcomes, particularly safety outcomes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

3.

Antipsychotic drugs for the acute treatment of patients with a first episode of schizophrenia: a systematic review with pairwise and network meta-analyses.

Author: ZhuYikang, KrauseMarc, HuhnMaximilian, RothePhilipp, Schneider-ThomaJohannes, ChaimaniAnna, LiChunbo, DavisJohn M, LeuchtStefan

Negative symptom reduction
Symptom reduction
Akathisia
Parkinsonian symptoms
Prolactin release
Weight gain

Haloperidol seems to be a suboptimal treatment option for acute treatment of first-episode schizophrenia, but we found little difference between second-generation antipsychotics. The evidence was generally of low quality and the numbers of patients for each drug were small.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

4.

Double-blind maintenance safety and effectiveness findings from the Treatment of Early-Onset Schizophrenia Spectrum (TEOSS) study.

Author: FindlingRobert L, JohnsonJacqueline L, McClellanJon, FrazierJean A, VitielloBenedetto, HamerRobert M, LiebermanJeffrey A, RitzLouise, McNamaraNora K, LinglerJacqui, HlastalaStefanie, PiersonLeslie, PugliaMadeline, MaloneyAnn E, KaufmanEmily Michael, NoyesNancy, SikichLinmarie

Side effects
Weight gain

In a long-term study of three antipsychotics in early-onset schizophrenia spectrum disorders, only 12% of participants remained on their original treatment after 52 weeks. No drug showed superior efficacy, and all were associated with adverse effects, including weight gain. Further research is needed to develop more effective and tolerable treatments for this population.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

5.

Hospitalization risk associated with typical and atypical antipsychotic use in community-dwelling elderly patients.

Author: AparasuRajender R, JanoElda, JohnsonMichael L, ChenHua

Antipsychotic adverse effects

Antipsychotic medications can have adverse effects in elderly patients, who are more susceptible due to age-related changes in drug metabolism and response. This abstract highlights the need for more research on the impact of antipsychotics on hospitalizations in the elderly.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Obesity and related metabolic abnormalities during antipsychotic drug administration: mechanisms, management and research perspectives.

Author: BaptistaT, KinN M K N Y, BeaulieuS, de BaptistaE A

Metabolic monitoring
Weight gain prevention
Diabetes
Dyslipidemia
Weight gain

Excessive body weight gain (BWG) is a common side effect of antipsychotic drugs (APs). Clozapine and olanzapine have the highest propensity to induce BWG. Patients should be monitored closely for BWG and metabolic dysfunction, and lifestyle changes should be encouraged.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

Psychosis during pregnancy: treatment considerations.

Author: PinkofskyH B

Psychosis treatment
Fetal side effects

This case study highlights the challenges of managing psychosis during pregnancy. The article discusses the risks and benefits of withholding or administering antipsychotic medication and examines the unique pharmacokinetic profile of molindone, a potential treatment option for psychosis in pregnancy.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Muscarinic m4 receptor activation by some atypical antipsychotic drugs.

Author: ZengX P, LeF, RichelsonE

Neuroleptic efficacy
Side effects

Clozapine is an atypical neuroleptic that acts as both a muscarinic receptor agonist and antagonist. Clozapine showed a concentration-dependent and atropine-sensitive inhibition on cAMP formation, with EC50 = 60 nM and Emax = 74% of carbachol maximum. Muscarinic m4 receptor agonism may be a relevant mechanism for the therapeutic efficacy and side effects of clozapine.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

9.

Bodyweight change as an adverse effect of drug treatment. Mechanisms and management.

Author: PijlH, MeindersA E

Bodyweight gain
Health risks

This study discusses drug-induced body weight gain and its implications for patient compliance and health risks.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

The use of molindone in the treatment of psychotic and delirious patients infected with the human immunodeficiency virus. Case reports.

Author: FernandezF, LevyJ K

Improved psychosis symptoms
Adverse side effects

This study found that molindone was effective in treating psychosis in four HIV-infected patients who were refractory to standard treatments. Molindone significantly controlled neuropsychiatric dysfunction without major adverse side effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Neuroleptic binding to muscarinic M2 receptors of normal human heart in vitro and comparison with binding to M1 and dopamine D2 receptors of brain.

Author: NeeperR, RichelsonE, NelsonA

Reduce extrapyramidal side effects
Cardiac side effects

The study examined the binding of 17 neuroleptics to muscarinic M2 receptors in human heart atrium. Thioridazine was the most potent compound, while molindone was the least potent. Few neuroleptics showed selectivity for M1 over M2 receptors, which could potentially reduce side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

14.

Relation of serum molindone levels to serum prolactin levels and antipsychotic response.

Author: PandurangiA K, NarasimhachariN, BlackardW G, LandaB S

Atypical antipsychotic
Mild side effects

Molindone showed therapeutic benefit in psychotic patients, with significant relations between serum levels and prolactin levels and treatment response.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

17.

The possible role of dopamine autoreceptors in neuroleptic atypicality.

Author: JavittD C, WeinsteinS L, OplerL A

Improved negative symptoms
Reduced tardive dyskinesia

Molindone, a novel neuroleptic, was found to preferentially inhibit dopamine autoreceptors, which may explain its distinct clinical effects, including reduced risk of tardive dyskinesia and improved negative schizophrenic symptoms.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

18.

Seizures with neuroleptics and antidepressants.

Author: MarkowitzJ C, BrownR P

Safer treatment for depression
Seizures

Seizures are a serious side effect of psychotropic drugs. This review discusses the seizurogenic potential of different medications, risk factors for seizures, and safer drug choices for high-risk patients.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

19.

The paw test: a behavioural paradigm for differentiating between classical and atypical neuroleptic drugs.

Author: EllenbroekB A, PeetersB W, HonigW M, CoolsA R

Predicting neuroleptic profile

The paw test, a novel animal model, was shown to be superior to the classical catalepsy test for predicting the profile of neuroleptics, highlighting its potential for drug development.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

21.

Clinical experience with molindone hydrochloride in geriatric patients.

Author: PeperM

Psychiatric Disorder Treatment
Well Tolerated
Extrapyramidal Side Effects

Molindone was safe and effective in 28 elderly patients with psychiatric disorders. Extrapyramidal side effects occurred in a small number of patients.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

22.

Comparison of injectable molindone and haloperidol followed by oral dosage forms in acutely ill schizophrenics.

Author: EscobarJ I, MannJ J, KellerJ, WilkinsJ, MasonB, MillsM J

Schizophrenia Treatment
Well Tolerated

Molindone and haloperidol were both effective and well tolerated in 35 patients with psychiatric disorders. No significant differences were found between the two drugs.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

23.

Bromocriptine associated with symptom exacerbation during neuroleptic treatment of schizoaffective schizophrenia.

Author: FryeP E, PariserS F, KimM H, O'ShaughnessyR W

Exacerbation of schizophrenia
Mental side effects

Bromocriptine, a dopamine agonist, can cause mental side effects. A patient with neuroleptic-induced remission of psychiatric symptoms experienced temporary exacerbation of schizophrenic symptoms after taking bromocriptine. Alternative treatments for amenorrhea-galactorrhea induced by neuroleptic medication are recommended. Close monitoring for mental status changes is crucial when using bromocriptine.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

24.

Comparison of molindone and tranylcypromine in the treatment of refractory depression.

Author: SmallJ G, KellamsJ J, DennisJ L, MilsteinV

Rapid response
Treats depression
Extrapyramidal symptoms

Molindone was found to be more effective and less toxic than tranylcypromine in treating treatment-resistant depression. Molindone produced a more rapid response and fewer disabling side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

25.

The clinical impact of reported variance in potency of antipsychotic agents.

Author: DewanM J, KossM

Antipsychotic efficacy
Misuse of antipsychotics

There is significant variation in the stated equivalences of antipsychotic agents in psychiatry, psychopharmacology, and pharmacology texts. This variation can lead to misuse of these agents, such as prescribing higher doses than necessary, leading to decreased efficacy and increased side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

26.

Induction patterns of Fos-like immunoreactivity in the forebrain as predictors of atypical antipsychotic activity.

Author: RobertsonG S, MatsumuraH, FibigerH C

Antipsychotic action
Reduced EPS

This study examined the effects of various antipsychotic drugs on c-fos expression in different brain regions. The results suggest that c-fos induction patterns may be useful in characterizing the actions of antipsychotics.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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