Journal of psychiatric research
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Randomized Controlled Trial Multicenter Study
Granisetron as an add-on to risperidone for treatment of negative symptoms in patients with stable schizophrenia: randomized double-blind placebo-controlled study.
Some 5-HT3 antagonists such as ondansetron have shown beneficial effects on negative symptoms of patients with schizophrenia. We aimed to evaluate the efficacy of granisetron (another 5-HT3 antagonist) add-on therapy in the treatment of negative symptoms of patients with stable schizophrenia. In a randomized, double-blind, and placebo-controlled study, forty stable patients with schizophrenia (DSM-IV-TR), were randomized to either granisetron (1 mg twice daily) or placebo (twice daily) in addition to risperidone up to 6 mg/day for eight weeks. ⋯ The ESRS score at week 4 was significantly lower in the granisetron than the placebo group while the two groups showed similar ESRS score at week 8. Frequency of other side effects was similar between the two groups. In summary, granisetron add-on can safely and effectively reduce the primary negative symptoms of patients with schizophrenia.
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This study examined the nature and determinants of longitudinal trajectories of disaster-related posttraumatic stress disorder (PTSD) symptoms in older persons affected by a large-magnitude disaster. Two hundred six adults age 60 or older (mean = 69, range = 60-92) who resided in the Galveston Bay area when Hurricane Ike struck in September 2008 completed telephone interviews an average of 3-, 6-, and 15-months after this disaster. Latent growth mixture modeling was employed to identify predominant trajectories of disaster-related PTSD symptoms over time; and pre-, peri-, and post-disaster determinants of these trajectories were then examined. ⋯ Greater number of traumatic and stressful life events, particularly financial problems after Hurricane Ike, was also associated with a delayed-onset trajectory. These findings suggest that there are heterogeneous trajectories of disaster-related PTSD symptoms in older adults and that these trajectories have common and unique determinants. They also underscore the importance of prevention efforts designed to mitigate the deleterious effects of post-disaster stressors, most notably financial distress, in older persons affected by disasters.
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The neurophysiological bases of cognitive-behavioral therapy (CBT) for obsessive-compulsive disorder (OCD) are incompletely understood. Previous studies, though sparse, implicate metabolic changes in pregenual anterior cingulate cortex (pACC) and anterior middle cingulate cortex (aMCC) as neural correlates of response to CBT. The goal of this pilot study was to determine the relationship between levels of the neurochemically interlinked metabolites glutamate + glutamine (Glx) and N-acetyl-aspartate + N-acetyl-aspartyl-glutamate (tNAA) in pACC and aMCC to pretreatment OCD diagnostic status and OCD response to CBT. ⋯ Lateralization of metabolite effects of CBT, previously observed in subcortical nuclei and white matter, may also occur in cingulate cortex. Tentative mechanisms for these effects are discussed. Comorbid depressive symptoms in OCD patients may have contributed to metabolite effects, although baseline and post-CBT change in depression ratings varied with choline-compounds and myo-inositol rather than Glx or tNAA.