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Background and Purpose: In recent years, review of opioid system and its changes in the psychopathology of schizophrenia through thear probable role our on neuronal synopses and cell body of dopaminergic neurons and also decrease dopamine secretion from acumbans nuclei and effects of opium agonists in treatment of those patients has been adventajes for clinicians.
Materials and methods: In a prospective double blind evaluation, 60 chronic schizophrenic inpatients on a stable regimen of neuroleptic medication with positive and negative symptom scale (PANSS) score of higher than 80 and were randomly assigned to either antipsychotic plus naltrexone or antipsychotic plus placebo. Thirty patients (30) received 100 mg/day of naltrexone plus antipsychotic drug while 30 received placebo plus antipsychotic drug for 6 weeks. PANSS scores were evaluated on the base of the study, biweekly through out the study and two weeks after the trial. The treatment effect was calculated by repeated measurement ANOVA.
Results: Difference between four types of symptoms (positive symptom, negative symptom, general psychopathological symptom, total score of PANSS) in the case and control groups was not significant (P < 0.05). In supplement two (S2) scores, a statistically non significant difference was seen in two groups (P < 0.07).
Conclusion: Additional treatment with 100 mg/day naltrexone in a 6 week trial had no significant therapeutic effect on typical or atypical antipsychotic drugs with regards to schizophrenia psychopathology.

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 Priapism is defined as the painful and prolonged penile erection in the absence of any sexual desire and arousal. It is considered as a urologic emergency and needs immediate attention as it can lead to sexual dysfunction. It has various etiologies, including idiopathic, medicinal, and medical ones. It is divided into two types: low-flow and high-flow. Medications, including quetiapine cause low-flow priapism. The aim of this study was to review the relationship between quetiapine use and priapism.
In most reports of drug-induced priapism, there was no relationship between the dose and duration of drug use. But a relationship was found between quetiapine use and priapism, due to overdose, continuous or single dose, and idiosyncratic reaction. Other than quetiapine, some other antipsychotics could also cause periapism. Recurrent priapism could happen in people with history of drug-induced priapism if the dug is continued. Priapism is associated with the mechanism of alpha1 adrenergic receptor blocking in the penis corpus cavernosum. The antipsychotics affinity to blocking this receptor are different and in quetiapine there is a moderate tendency. Co-administration of CYP450 inhibitors with quetiapine increases some complications such as priapism, and vice versa the inducers of these enzymes, such as smoking, alongside quetiapine decrease this complication by reducing serum levels of the drug. Awareness about the possibility of complications of quetiapine by physicians lead to prompt diagnosis and treatment, thereby preventing other associated complications.

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Background and purpose: Memantine is a medication used to treat moderate to severe Alzheimer^’s disease. Memantine targeting the glutamatergic system specifically N-Methyl-D-Aspartate offer a novel approach in treatment of psychiatric disorders such as schizophrenia and schizoaffective disorder. The purpose of this study was to evaluate the efficacy and safety of memantine in combination with antipsychotics in patients with schizophrenia and schizoaffective disorder.
Materials and methods: A double-blind, placebo-controlled trial was performed in patients aged 18-65 years old with confirmed diagnosis of schizophrenia and schizoaffective disorder. Those who were pregnant, allergic to memantine, and not willing to participate in the study were excluded. Participants were assigned to receive either memantine (5-20 mg/day) (n= 29) or placebo (n= 29), in addition to antipsychotic for 90 days. The Positive and Negative Syndrome Scale (PANSS) was completed at baseline and day 30 and 90.
Results: The study showed no significant difference in reduction of PANSS scores for positive sign between the treatment group (6.32±7.17) and controls (4.17±6.25) (P=0.07).
Conclusion: Memantine was found to have no effect on positive sign of schizophrenia and schizoaffective disorder.
 
(Clinical Trials Registry Number: IRCT: 201310083210N5)
 
 

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 Olanzapine (2-methyl-4-(4-methylpiperazin-1-yl)-10H-thieno [2, 3-b][1, 5]benzodiazepine) is an antipsychotic drug with poor water-solubility that has a suitable affinity to some receptors. This benzodiazepine derivative is a new (atypical) antipsychotic drug and has a wide range of efficacy, especially in treatment of patients with negative psychiatric symptoms of schizophrenia. Olanzapine is used in psychotic disorders, mood disorders, and acute restlessness in bipolar patients. Its oral absorption is low and about 40% of the drug is metabolized in first-pass hepatic metabolism. This drug has low permeability into the brain related to remove by p-glycoprotein efflux and blood-brain-barrier (BBB) existence. Emerging nanotechnology during recent years demonstrated the tremendous ability of nanoparticles as versatile nanocarrier systems. This emerging technology has raised promising attempts to address the significant impact on decreasing side effects of drugs and their associated defects. Olanzapine can be administrated by different routes. Intranasal delivery of olanzapine to the brain due to lack of blood-brain-barrier in the olfactory system has facilitated its delivery. In this review article, several olanzapine nano-drug delivery systems are listed by reviewing their results, including nanosuspensions, nanoemulsions, solid lipid nanoparticles (SLN), niosomes, transfersomes, nanostructured lipid carriers (NLC), polymeric nanoparticles (PNP), etc.