The Journal of clinical psychiatry
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We conducted a retrospective epidemiologic study assessing the incidence of new-onset diabetes mellitus presenting as diabetic ketoacidosis in patients with schizophrenic disorders (ICD-9 295.0-295.9; referred to as "schizophrenia patients" hereafter) treated with atypical antipsychotic agents. ⋯ The incidence of diabetes mellitus presenting as diabetic ketoacidosis in schizophrenia patients is higher than in the general hospital population and differs across atypical antipsychotic agents. Elevated HgbA1c levels observed suggests that patients had undiagnosed diabetes mellitus for at least several weeks before the diabetic ketoacidosis episode.
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Randomized Controlled Trial Comparative Study
A randomized controlled trial of olanzapine versus haloperidol in the treatment of primary negative symptoms and neurocognitive deficits in schizophrenia.
Primary negative symptoms are intrinsic to the pathology of schizophrenia and are associated with significant deficits in motivation, verbal and nonverbal communication, affect, and cognitive and social functioning. Overall, atypical antipsychotic medications have been found to be more efficacious than conventional antipsychotics in the treatment of negative symptoms, based on studies with acute patients. Results have been confounded by concomitant improvements in positive, depressive, and extrapyramidal symptoms. This 12-week, double-blind, controlled study aimed to examine the effects of the atypical antipsychotic olanzapine versus haloperidol on persistent, primary negative symptoms and neurocognitive functions in stable schizophrenic patients with the deficit syndrome and low levels of concomitant positive, depressive, and extrapyramidal symptoms. ⋯ The results of this study suggest that olanzapine treatment was associated with significant improvement in primary negative symptoms, overall symptomatic improvement as measured by the PANSS total score, and improvement in some areas of neurocognition as compared with haloperidol/benztropine mesylate treatment.
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The aim of the study was to assess the external and internal validity of the 6- and 17-item versions of the Hamilton Rating Scale for Depression (HAM-D(6) and HAM-D(17)), the Bech-Rafaelsen Melancholia Scale, the 15- and 30-item versions of the Geriatric Depression Scale, and the Cornell Scale for Depression in Dementia in a population of depressed demented and nondemented Danish elderly. ⋯ The HAM-D(6) should be separately considered even when longer HAM-D versions are used for the measurement of depression in elderly persons.
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To gain insight into factors affecting the rate of decline in placebo-treated subjects participating in Alzheimer's disease (AD) clinical trials. ⋯ Study duration was the only variable that predicted decline consistently, whereas the number of evaluations, the number of sites, and baseline MMSE score are inversely proportional with decline and should be taken into account when planning future clinical trials.
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Randomized Controlled Trial
Melatonin in schizophrenic outpatients with insomnia: a double-blind, placebo-controlled study.
Low nighttime levels of melatonin have been demonstrated in patients with insomnia, and melatonin has been shown to have hypnotic properties in some groups of such subjects. Low melatonin levels have also been observed in patients with schizophrenia; however, there is little literature on the efficacy of exogenous melatonin in treating insomnia associated with schizophrenia. ⋯ Melatonin may be a useful short-term hypnotic for schizophrenic patients with insomnia. Melatonin could be considered for patients in whom conventional hypnotic drug therapy or higher sedative antipsychotic drug doses may be problematic.