The AACP established its Clinical Research Award in 1979, which is presented to the author of the best original research paper published in Annals of Clinical Psychiatry during the previous calendar year. The Award is presented at the AACP annual meeting and includes a cash prize, engraved award, complimentary one-year membership to the AACP, plus travel and accommodations to attend the annual meeting. The AACP’s Research Award Committee is responsible for making the selection.

2022 George Winokur Clinical Research Award Winner
Ana M. Lupu, PharmD

Less is more: Deprescribing anticholinergic medications in persons with severe mental illness

The American Academy of Clinical Psychiatrists 2022 George Winokur Research Award has been awarded to Ana Lupu, PharmD, for research published in 2021 in the Annals of Clinical Psychiatry, May 2021/Vol. 33 No.2. Dr. Lupu will be presented the award at the upcoming AACP Annual Conference (Spring Psychiatry Update 2023) in Chicago, in March 2023. (For further information go to www.CPAACP-CME.com.)

The Annals of Clinical Psychiatry provides an international forum for exploring the etiology, diagnosis, and treatment of psychiatric disorders, publishing high-quality, peer-reviewed articles focused on advancing patient care, including original research, timely reviews, case reports, letters to the editor, and book reviews. The Annals are indexed with the National Library of Medicine.

Dr. Lupu’s research article is titled “Less is more: Deprescribing anticholinergic medications in persons with severe mental illness,” Annals of Clinical Psychiatry/Vol. 33 No. 2, May 2021. While not routinely recommended, long-term treatment with anticholinergic medications for antipsychotic-associated extrapyramidal symptoms (EPS) is widely prevalent. Anticholinergic medications are associated with adverse effects such as dry mouth, constipation, blurred vision, urinary retention, and tachycardia–all of which significantly impact quality of life in patients with severe mental illness (SMI). Moreover, anticholinergic medications increase cognitive impairment and risk of delirium, which are of particular concern in patients with schizophrenia and other SMI who are often taking concomitant medications that increase these risks. This article describes a multidisciplinary approach to deprescribing anticholinergic medications for EPS and illustrates how reducing anticholinergic burden can reduce side effects and improve quality of life in this patient population.

METHOD: Education directed at psychiatrists combined with clinical pharmacy support for deprescription was used to target clinically stable patients diagnosed with schizophrenia, schizoaffective disorder, or bipolar disorder with no EPS and ACM prescriptions ≥6 months. Scales were used to assess anticholinergic adverse effects, memory impairment, and quality of life. ACMs were tapered and discontinued over 1 to 6 months.

RESULTS: More than 75% of targeted patients successfully tapered or discontinued ACM, which coincided with significant improvements in anticholinergic adverse effects, memory impairment, and quality of life. Approximately 10% of patients were restarted on ACM for re-emergent EPS.

CONCLUSIONS: For most clinically stable patients with SMI without EPS, our findings suggest that gradual deprescription of chronic ACM is clinically appropriate, well tolerated, and improves quality of life. A randomized trial could provide more definitive answers.

Ana Maria Lupu, PharmD, attended the University of Pittsburgh School of Pharmacy, Doctor of Pharmacy Program, completing her degree in 2010, and completed her postgraduate training at Duquesne University and the University of Pittsburgh School of Pharmacy. Dr. Lupu is currently employed as a Clinical Pharmacist, Ambulatory Care, at Forbes Pharmacy, UPMC Western Psychiatric Hospital in Pittsburgh, providing medication management services for patients with SMI. She has also been an Adjunct Instructor of Pharmacy and Therapeutics at the University of Pittsburgh School of Pharmacy since 2013.

 

Contact Information for Dr. Lupu
Ana M. Lupu, PharmD
3501 Forbes Ave. Suite 756
Pittsburgh, PA 15213
[email protected]

Research team Included:
Ana M. Lupu, PharmD
Kathryn L. MacCamy, PharmD, BCPS
Jessica M. Gannon, MD
Jaspreet S. Brar, MBBS, MPH, PhD
K.N. Roy Chengappa, MD, FRCPC

George Winokur Research Award Committee:
Richard Balon, MD, Wayne State University
Detroit, MI
James Wilcox, MD, PhD, University of Arizona College of Medicine
Phoenix, AZ

Please contact Beverly Davidson, Executive Director, AACP, for further information at [email protected], or call (920) 395-2330.

 

George Winokur Clinical Research Award Winners

Winners	Runners-up	Committee Chair
1979 David Kupfer, MD	Mark Gold, MD	Charles L. Rich, MD
1980 Larry E. Tune, MD	James R. Morrison, MD Robert E. Smith, MD	Louis Hafken, MD
1981 Hagop S. Akiskal, MD	Henry A. Nasrallah, MD	Louis Hafken, MD
1982 Sheldon H. Preskorn, MD	Larry Kirstein, MD	Louis Hafken, MD
1983 Ming T. Tsuang, MD, PhD	Gary Tollefson, MD, PhD	Louis Hafken, MD
1984 Elizabeth B. Weller, MD	Hector C. Fabelli, MD, PhD	Louis Hafken, MD
1985 Natraj Sitaram, MD	Matig Mavissakalian, MD	Louis Hafken, MD
1986 Dennis S. Charney, MD	Arnold L. Lieber, MD	Louis Hafken, MD
1987 Michael Liebowitz, MD	Harry E. Gwirtsman, MD	Louis Hafken, MD
1988 Ronald A. Weller, MD	Joyce G. Small, MD	Charles L. Rich, MD
1989 Conrad M. Swartz, MD	Timothy D. Brewerton, MD	Valerie F. Holmes, MD
1990 Conrad M. Swartz, MD		Valerie F. Holmes, MD
1991 Douglas Finestone, MD	Ira Glick, MD	Valerie F. Holmes, MD
1992 Roy T. Mathew, MD	Stephen C. Olsen, MD	Valerie F. Holmes, MD
1993 Elizabeth M. Smith, PhD		Valerie F. Holmes, MD
1994 Joesph Magliozzi, MD (co-winner) John Lauer, MD (co-winner)		Paul M. Packman, MD
1995 Laura Sanchez, MD		Paul M. Packman, MD
1996 Mary Fristad, PhD		Paul M. Packman, MD
1997 Danielle S. Schneider, MD		Donald W. Black, MD
1998 Donald W. Black, MD		Donald W. Black, MD
1999 Sidney Zisook, MD		Donald W. Black, MD
2000 Eric Lenze		Donald W. Black, MD
2001 Liviu Ichim MD		Donald W. Black, MD
2002 Paul J. Perry PhD		Donald W. Black, MD
2003 Betty Pfefferbaum, MD		Donald W. Black, MD
2004 (No Award Presented)
2005 Matig Massavikalian, MD		Carol S. North, MD
2006 Pinhas Nedim Dannon, MD		Carol S. North, MD
2007 Keith E. Isenberg, MD		Carol S. North, MD
2008 Ahsan Y. Khan, MD		Carol S. North, MD
2009 George I. Papakostas, MD		Carol S. North, MD
2010 Susan K. Schultz, MD
2011 Doreen Granpeesheh, PhD, BCBA-D		Carol S. North, MD
2012 Alina Suris, PhD, ABPP		Carol S. North, MD
2013 Donald Black, MD		Carol S. North, MD
2014 Boaz Levy, PhD		Carol S. North, MD
2015 Alina Suris		Carol S. North, MD
2016 Mark Zimmerman		Carol S. North, MD
2017 William Lawson, MD, PhD		Carol S. North, MD
2018 Keith E. Isenberg, MD		Carol S. North, MD
2019 Gus Zhang, MD		Carol S. North, MD
2020 Laura Madson, PhD		Carol S. North, MD