Dose reduction of risperidone and olanzapine can improve cognitive function and negative symptoms in stable schizophrenic patients: A single-blinded, 52-week, randomized controlled study

2018 ◽  
Vol 32 (5) ◽  
pp. 524-532 ◽  
Author(s):  
Yanling Zhou ◽  
Guannan Li ◽  
Dan Li ◽  
Hongmei Cui ◽  
Yuping Ning
Keyword(s):  
Side Effects ◽  
Dose Reduction ◽  
Negative Symptom ◽  
Negative Symptoms ◽  
Rating Scale ◽  
Symptom Assessment ◽  
Extrapyramidal Side Effects ◽  
Syndrome Scale ◽  
Schizophrenic Patients ◽  
Negative Syndrome

Background: The long-term effects of dose reduction of atypical antipsychotics on cognitive function and symptomatology in stable patients with schizophrenia remain unclear. We sought to determine the change in cognitive function and symptomatology after reducing risperidone or olanzapine dosage in stable schizophrenic patients. Methods: Seventy-five stabilized schizophrenic patients prescribed risperidone (≥4 mg/day) or olanzapine (≥10 mg/day) were randomly divided into a dose-reduction group ( n=37) and a maintenance group ( n=38). For the dose-reduction group, the dose of antipsychotics was reduced by 50%; for the maintenance group, the dose remained unchanged throughout the whole study. The Positive and Negative Syndrome Scale, Negative Symptom Assessment-16, Rating Scale for Extrapyramidal Side Effects, and Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery were measured at baseline, 12, 28, and 52 weeks. Linear mixed models were performed to compare the Positive and Negative Syndrome Scale, Negative Symptom Assessment-16, Rating Scale for Extrapyramidal Side Effects and MATRICS Consensus Cognitive Battery scores between groups. Results: The linear mixed model showed significant time by group interactions on the Positive and Negative Syndrome Scale negative symptoms, Negative Symptom Assessment-16, Rating Scale for Extrapyramidal Side Effects, speed of processing, attention/vigilance, working memory and total score of MATRICS Consensus Cognitive Battery (all p<0.05). Post hoc analyses showed significant improvement in Positive and Negative Syndrome Scale negative subscale, Negative Symptom Assessment-16, Rating Scale for Extrapyramidal Side Effects, speed of processing, working memory and total score of MATRICS Consensus Cognitive Battery for the dose reduction group compared with those for the maintenance group (all p<0.05). Conclusions: This study indicated that a risperidone or olanzapine dose reduction of 50% may not lead to more severe symptomatology but can improve speed of processing, working memory and negative symptoms in patients with stabilized schizophrenia.

Carbonyl stress in schizophrenia

2014 ◽  
Vol 42 (2) ◽  
pp. 468-472 ◽  
Author(s):  
Masanari Itokawa ◽  
Mitsuhiro Miyashita ◽  
Makoto Arai ◽  
Toshio Miyata
Keyword(s):  
Vitamin B6 ◽  
Negative Symptoms ◽  
Therapeutic Agent ◽  
Active Form ◽  
Carbonyl Stress ◽  
Research Approach ◽  
Treatment Resistant ◽  
Syndrome Scale ◽  
Schizophrenic Patients ◽  
Negative Syndrome

We have identified idiopathic carbonyl stress in a subpopulation of schizophrenic patients. We first identified a patient with a mutation in GLO1 (glyoxalase I) who showed increased AGE (advanced glycation end-product) levels and decreased vitamin B6 levels. By applying the observations from this rare case to the general schizophrenic population, we were able to identify a subset of patients (20%) for whom carbonyl stress may represent a causative pathophysiological process. Genetic defects in GLO1 increase the risk of carbonyl stress 5-fold, and the resulting increased AGE levels correlate significantly with PANSS (Positive and Negative Syndrome Scale) scored negative symptoms. Pyridoxamine, an active form of vitamin B6 and scavenger for carbonyl stress, could represent a novel and efficacious therapeutic agent for these treatment-resistant symptoms. In the present article, we describe a unique research approach to identify the causative process in the pathophysiology of a subset of schizophrenia. Our findings could form the basis of a schizophrenia subtype classification within this very heterogeneous disease and ultimately lead to better targeted therapy.

scholarly journals Prevalence and correlates of antipsychotic polypharmacy among outpatients with schizophrenia attending a tertiary psychiatric facility in Nigeria

2016 ◽  
Vol 7 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Nosa Godwin Igbinomwanhia ◽  
Sunday Osasu Olotu ◽  
Bawo Onesirosan James
Keyword(s):  
Psychosocial Functioning ◽  
Side Effect ◽  
Negative Symptoms ◽  
Rating Scale ◽  
Cross Sectional Study ◽  
Global Assessment Of Functioning ◽  
Psychiatric Facility ◽  
Cross Sectional ◽  
Syndrome Scale ◽  
Negative Syndrome

Background: The study aimed to determine the prevalence, pattern and correlates of antipsychotic polypharmacy (APP) among outpatients with schizophrenia attending a tertiary psychiatric facility in Nigeria. Method: A cross-sectional study of 250 patients with schizophrenia attending the outpatient clinic of a regional tertiary psychiatric facility in Nigeria was undertaken. They were administered a sociodemographic questionnaire, the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF) scale and the Liverpool University Side Effects Rating Scale (LUNSERS). Results: Of the 250 subjects interviewed, 176 (70.4%) were on APP. APP was significantly associated with higher prescribed chlorpromazine equivalent doses of antipsychotics ( p < 0.001), increased frequency of dosing ( p < 0.001), negative symptoms ( p < 0.01), poorer functioning ( p = 0.04) and greater side-effect burden ( p = 0.04). Conclusion: The APP rate reported from this study is high. Clinicians should be mindful of its impact on dosage and side-effect profiles as APP use is associated with negative symptoms and poor psychosocial functioning.

Poor memory, negative symptoms and abnormal movements in never-treated Indian patients with schizophrenia

1997 ◽  
Vol 171 (4) ◽  
pp. 360-363 ◽  
Author(s):  
R. G. McCreadie ◽  
S. Latha ◽  
R. Thara ◽  
R. Padmavathi ◽  
J. R. Ayankaran
Keyword(s):  
Negative Symptoms ◽  
Normal Subjects ◽  
Treated Group ◽  
Confounding Variable ◽  
Wechsler Memory Scale ◽  
Abnormal Movements ◽  
Syndrome Scale ◽  
Schizophrenic Patients ◽  
Negative Syndrome ◽  
Poor Memory

BackgroundCognitive impairment, frequently found in patients with schizophrenia, may be associated with negative symptoms and dyskinesia. However, antipsychotic medication may be a confounding variable. These putative associations may be clarified by examining never-treated patients.MethodNever-treated elderly schizophrenic patients (n=19) living in south-east India were compared with treated patients (n=25) and normal subjects (n=55). Memory was assessed by the Wechsler Memory Scale, negative symptoms by the Positive and Negative Syndrome Scale, and dyskinesia by the Abnormal Involuntary Movements Scale.ResultsNormal subjects had a higher mean memory quotient than patients. There were no significant differences between never-treated and treated patients. Negative symptoms were associated with a poorer memory in the never-treated group. There was no association between memory and dyskinesia.ConclusionsThere is an association in never-treated patients between a poorer memory and negative symptoms, but not between a poorer memory and dyskinesia.

scholarly journals THE DIFFERENCES SCORE OF POSITIVE AND NEGATIVE SYNDROME SCALE NEGATIVE SCALE BETWEEN SCHIZOPHRENIC PATIENTS THAT RECEIVED RISPERIDONE AND RISPERIDONE WITH FLUOXETINE

2018 ◽  
Vol 11 (13) ◽  
pp. 39
Author(s):  
Ritha M Sembiring ◽  
Mustafa M Amin ◽  
Elmeida Effendy
Keyword(s):  
Negative Symptoms ◽  
Study Finding ◽  
Positive Symptom ◽  
Open Label ◽  
Syndrome Scale ◽  
Classification Of Diseases ◽  
Primary Finding ◽  
Schizophrenic Patients ◽  
International Statistical Classification ◽  
Negative Syndrome

 Objective: Negative symptoms are relatively common with a recent study finding that nearly 58% of outpatients had at least one negative symptom, negative symptoms are better predictors of functioning than positive symptom. Antidepressants have been a natural and common choice for the treatment of negative symptoms considering the conceptual proximity of their mode of action and the etiological hypotheses involving related neurotransmitters. This study examined differences negative symptoms scale score between patient that received only risperidone and risperidone with fluoxetine.Method: The sample consist of 44 patients with a diagnosis of schizophrenia according to ICD-10 (International Statistical Classification of Diseases), male, age ranged was between 30 and 50 years, signed informed consent before entering into study which had been conducted at the Prof. Dr. M Ildrem Mental Health Hospital Medan Sumatera Utara Indonesia. The study was designed for 4 weeks, open-label, divided into two groups of 22 each, (1) receiving 4 mg/day risperidone with 20 mg/day fluoxetine and (2) receiving only 4 mg/day risperidone. Negative symptoms were assessed using positive and negative syndrome scale (PANSS).Results: The primary finding of the trial was a significant reduction in score ofnegativescale in patients receiving risperidone with fluoxetinecompared to patients receiving only risperidone at the end of 4 weeks. All the subscales of PANSS negative symptoms scale demonstrated significant improvement.Conclusions: In patients with schizophrenia, treating negative symptoms with adjunctive to fluoxetine appears to carry the benefit of improving negative symptoms.

Relationship between Neuroleptic Dose and Positive and Negative Symptoms

1994 ◽  
Vol 74 (2) ◽  
pp. 481-482 ◽  
Author(s):  
Patrick B. Johnson ◽  
Lewis A. Opler ◽  
Paul M. Ramirez ◽  
Robert Malgady
Keyword(s):  
Side Effects ◽  
Negative Symptom ◽  
Negative Symptoms ◽  
Zero Order ◽  
Standardized Assessments ◽  
Symptom Scores ◽  
Medication Dose ◽  
Schizophrenic Patients ◽  
Positive And Negative Symptoms

The present study explored possible connections between neuroleptic dose and the positive and negative symptoms of schizophrenic patients. Zero-order correlations between medication dose as measured in CPZ equivalent units and standardized assessments of positive (hallucinations, delusions) and negative (blunted affect, poor rapport) symptoms were carried out on 28 hospitalized schizophrenics. While dose was positively related to over-all negative symptom scores as well as specific negative symptoms, no relation was found with positive scores. The discussion focused on the possibility that negative symptoms might represent medication-induced side effects and the need for further research.

scholarly journals The polymorphic variants DRD2 rs1800497 and ABCB1 3435C>T are associated with antipsychotic safety parameters in adolescents with an acute psychotic episode: the results of a pilot study

2020 ◽  
Vol 12 (5) ◽  
pp. 24-31
Author(s):  
D. V. Ivashchenko ◽  
S. Z. Khoang ◽  
M. Kh. Tazagulova ◽  
B. V. Makhmudova ◽  
N. I. Buromskaya ◽  
...  
Keyword(s):  
Side Effects ◽  
Rating Scale ◽  
Subscale Score ◽  
Psychotic Episode ◽  
Global Assessment Scale ◽  
Syndrome Scale ◽  
Safety Parameters ◽  
Polymorphic Variants ◽  
Negative Syndrome

Children and adolescents are more likely than adults to experience adverse side effects when taking antipsychotics. Pharmacogenetic testing allows one to more accurately choose the initial dose of a drug. The genes of pharmacokinetic factors have been shown to be of high prognostic value for the safety of antipsychotics in adults.Patients and methods. The study enrolled 36 adolescents (58.3% male) (mean age, 14.83±1.84 years). All the patients took an antipsychotic. The follow-up lasted 28 days. On 14 and 28 days of treatment, its efficiency and safety were evaluated using the Children's Global Assessment Scale (CGAS), the Positive and Negative Syndrome Scale (PANSS), the Udvalg for Kliniske Undersњgelser Side Effects Rating Scale (UKU-SERS), the Simpson-Angus Scale (SAS), and the Barnes Akathisia Rating Scale (BARS). The patients were genotyped for CYP3A4*22, CYP3A5*3, CYP2D6*4, *9, *10, ABCB1 1236C>T, 2677G>T/A, 3435C>T, DRD2 rs1800497, DRD4 rs1800955, and HTR2A rs6313.Results and discussion. The decrease in the mean score of the PANSS subscale “Productive symptoms” was more pronounced in carriers of the DRD2 rs1800497 polymorphic variant (-6.5 [-10.25; -3.75] vs -3 [-6.5; -2 ] on 14 day (p=0.028) and (-11 [-13; -9.5] vs -5 [-9; -3.5] on 28 day (p=0.001) compared to baseline. The carriage of ABCB1 3435CT+TT was associated with worse tolerance to pharmacotherapy on 14 day (the total score of the UKU-SERS M, 8 [3; 11.75] vs M, 2 [1; 6]; p=0.034). The carriers of DRD2 rs1800497 reported a greater severity of antipsychotic-induced neurological disorders (UKU-SERS subscale score M, 1 [0; 2.25] vs M 0 [0; 1]; p=0.029).Conclusion. The polymorphic variants DRD2 rs1800497 and ABCB1 3435C>T were established to be significantly associated with the efficacy and safety of antipsychotics in adolescents with an acute psychotic episode.

Movement Disorder in Never and Minimally Treated Nigerian Schizophrenic Patients

1994 ◽  
Vol 164 (2) ◽  
pp. 184-189 ◽  
Author(s):  
Robin G. McCreadie ◽  
Jude U. Ohaeri
Keyword(s):  
Movement Disorder ◽  
Antipsychotic Medication ◽  
Mental State ◽  
Movement Disorders ◽  
Negative Symptoms ◽  
Abnormal Involuntary Movements ◽  
Syndrome Scale ◽  
Schizophrenic Patients ◽  
Negative Syndrome ◽  
Barnes Akathisia Scale

Two hundred and forty-two Nigerian schizophrenic patients (63% male, 37% female), whose mean age was 42 years and length of illness 12 years, were examined for movement disorders using the Abnormal Involuntary Movements Scale, the Simpson and Angus Parkinsonism Scale and the Barnes Akathisia Scale. Twelve patients had never received antipsychotic medication; and none of these had dyskinesia. Dyskinesia was found in 5 of 49 patients (10%) who had taken medication throughout the course of their illness for a total of up to 3 months, 13 of 74 (18%) who had taken medication for 4–12 months, 14 of 41 (34%) for 1–5 years, and 29 of 66 (45%) who had taken medication for more than 5 years. Of 77 patients who were receiving antipsychotic medication at the time of examination, 9 (12%) had Parkinsonism and 12 (15%) akathisia. Examination of the patients' mental state by the Positive and Negative Syndrome Scale showed an association between dyskinesia and positive, but not negative, schizophrenic symptoms. Nigerian patients showed a low level of negative symptoms.

A clinimetric analysis of a BPRS-6 scale for schizophrenia severity

2018 ◽  
Vol 30 (4) ◽  
pp. 187-191 ◽  
Author(s):  
Per Bech ◽  
Stephen F Austin ◽  
Nina Timmerby ◽  
Thomas A Ban ◽  
Stine Bjerrum Møller
Keyword(s):  
Negative Symptoms ◽  
Rating Scale ◽  
Theory Model ◽  
Primary Objective ◽  
Clinical State ◽  
Clinical Validity ◽  
Syndrome Scale ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Negative Syndrome

ObjectiveA restricted Brief Psychiatric Rating Scale (BPRS-6) with the six schizophrenia specific items from the Positive and Negative Syndrome Scale (PANSS) has been investigated. These six items from the PANSS have recently been found to have both clinical validity and ‘unidimensionality’ in measuring the severity of schizophrenic states. The primary objective of this study was to evaluate the clinical validity of the BPRS-6. The secondary objective was to evaluate the ‘unidimensionality’ of the BPRS-6 by an ‘item response theory’ model.MethodsThe BPRS-6 was scored independently by two psychiatrists and two psychologists while viewing six open-ended videotaped interviews in patients with a DSM-III diagnosis of schizophrenia. The interviews were conducted by Heinz E. Lehmann, an experienced psychiatrist. They were focused on the psychopathology that contributed most to the ‘severity’ of the patient’s clinical state.ResultsThe BPRS-6 with three positive symptoms (delusions, conceptual disorganisation, hallucinations) and three negative symptoms (blunted affect, emotional withdrawal, poverty of speech) was found to be clinically valid and captured the variables that contribute most to the severity of schizophrenia. The BPRS-6 was also found to have acceptable ‘unidimensionality’ (coefficient of homogeneity 0.45) and inter-rater reliability (inter-class-coefficient 0.81).ConclusionThe BPRS-6 was found to capture the information that translates into the severity of schizophrenia. It has also acceptable psychometric validity.

The Safety and Efficacy of Clozapine in Severe Treatment-Resistant Schizophrenic Patients in the UK

1993 ◽  
Vol 163 (2) ◽  
pp. 150-154 ◽  
Author(s):  
C. E. Adams ◽  
T. R. E. Barnes ◽  
M. A. Essali ◽  
S. R. Hirsch ◽  
A. V. P. MacKay ◽  
...  
Keyword(s):  
Adverse Event ◽  
Side Effects ◽  
Negative Symptoms ◽  
Extrapyramidal Side Effects ◽  
Treatment Resistant ◽  
Frequent Adverse Event ◽  
Safety And Efficacy ◽  
Schizophrenic Patients ◽  
The Uk ◽  
Positive And Negative Symptoms

In order to assess the safety and some efficacy aspects of clozapine under UK conditions, 54 in-patients with severe treatment-resistant schizophrenic disorders were evaluated using several scales before and during treatment. Of the 54 evaluated, 26 completed the 26-week study. Of these patients, 20 showed improvement in psychopathology, often to a marked degree, involving both positive and negative symptoms. Some oral-facial extrapyramidal side-effects decreased as well. Two patients developed neutropenia, but recovered on discontinuation of clozapine. The most frequent adverse event was hypersalivation, and five patients suffered from seizures. It is concluded that clozapine is worth considering for the treatment of severe treatment-resistant patients in the UK.

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