02 Декабрь, 2002
Abortion pill relieves psychotic depression
Vithal C Nadkarni 12/01/2002 : According to some feminists, if it weren't for the anti-abortion groups, the drug mifepristone, commonly known as RU486, would be a candidate for the Nobel Prize. The Economic Times via NewsEdge Corporation : Vithal C Nadkarni 12/01/2002 : According to some feminists, if it weren't for the anti-abortion groups, the drug mifepristone, commonly known as RU486, would be a candidate for the Nobel Prize. The story of Viagra for men, on the other hand, is strikingly different. The three scientists whose work led to the use of the wildly popular anti-impotence drug have already won the Nobel Prize. However, not all is lost. Research with mifepristone in recent years has uncovered a plethora of possible health-care benefits-- some for diseases that no other drug can treat. So, Dr Etienne- Emile Baulieu, the French scientist who invented RU486, could possibly end up having the last laugh at his opponents. The abortion pill may have use as an anti-depressant, small-scale study recently carried out by him along with a team from Stanford University in California has shown. Moreover, the US Food & Drug Administration is fasttracking approval for the pill's new avatar, a first for a psychiatric drug in America, after a study in the 'Journal of Biological Psychiatry' concluded that RU486 brought remarkably fast relief to people suffering from acute psychotic depression. Psychotic symptoms affect about 15 per cent of patients suffering from major depression who experience paranoid delusions and hallucinations, such as guilt for imaginary crimes, along with the usual features of depression such as hopelessness and a crippling sense of anxiety. Anti-depressant drugs alone are usually ineffective. Combining anti-depressants with anti- psychotics improves symptoms for only about 60 per cent of patients, according to Stanford researchers. The good news is that electro-convulsive or shock therapy works in roughly 80 per cent of the patients who try it. However, many decline the treatment because of its widespread stigma. In addition, researchers say patients undergoing shock therapy or drug combinations may not see results for weeks or even months after starting treatment. Because of the high risk of suicide involved these cases, experts have long been rooting for quicker-acting alternatives. Against this backdrop, Dr Baulieu told the news agency Agence France Presse that RU486 can save lives. "A week's treatment with the drug helps the patient to overcome the danger and return to normal medication," he added. In a phase-II multi-centric study conducted by Dr Baulieu and his American colleagues, 30 patients received a low, medium or high dose of mifepristone each day for a week, in addition to their standard medicines. More than two-thirds of patients in the medium- and high-dose groups showed significant reductions in psychotic symptoms within seven days, according to the researchers. During the week, more than 40 per cent of the patients in these groups saw their symptoms of their depression reduced by half or better, based on standard clinical measures of the disease. The social implications of the treatment are profound, according to Dr Alan Schatzberg, chairman of Stanford's psychology department, both because mifepristone might eliminate the need for shock treatments and because it comes from a drug with other uses that some people don't like. RU486 was originally developed as a steroid treatment for Cushing's disease, to block the hormone cortisol secreted by the adrenal glands. However, since cortisol receptors and progesterone receptors are structurally related, scientists found that at lower doses, the drug also blocks progesterone, which is required for implanting a fertilised egg in the lining of the uterus. This made it useful as an abortifacient and, in even smaller doses, as an emergency contraceptive. Cortisol, on the other hand, plays a critical role in the body's response to stress. Research in last two decades has revealed that cortisol is extremely elevated in psychotically depressed patients. In these patients, the natural feedback loop involving the stress hormone is thought to be awry, with sustained levels of the chemical leading to symptoms such as hallucinations, sleep disturbances and memory problems. Meanwhile, doctors and researchers have been heartened by other potential uses of mifepristone that have emerged in recent years. These include treatments for uterine fibroids and several types of cancer and even ailments such as Alzheimer's and AIDS. Says Dr Beth Jordon, medical director of the US-based Feminist Majority Foundation, "It's high time that the life-saving potential of mifepristone was released from the shackles of anti-abortion politics", even as the so-called anti-choice organisations continue to mount fresh assaults against the abortion pill. Copyright 2002. All Rights Reserved. Financial Times Information Limited - Asia Africa Intelligence Wire <> << Copyright ©2002 Financial Times Limited, All Rights Reserved >>
02 Декабрь, 2002
Drug Trends - Analysis/ Company hopes to find growth in depression market with duloxetine
Decision Resources, Inc., forecasts that Eli Lilly's new serotonin norepinephrine reuptake inhibitor , duloxetine, will be the most promising drug to be launched between 2001-201. Drug Week via NewsEdge Corporation : Decision Resources, Inc., forecasts that Eli Lilly's new serotonin norepinephrine reuptake inhibitor (SNRI), duloxetine, will be the most promising drug to be launched between 2001-201. Duloxetine posses a mechanism of action similar to that of venlafaxine, a popular SNRI already on the market. "Although both Wyeth's venlafaxine and Lilly's duloxetine will share approximately 20% of the depression market in 2011, duloxetine will be favored over venlafaxine because it is not as likely as venlafaxine to cause high blood pressure," said Anathea Waitekus, analyst at Decision Resources. She concluded: "Duloxetine's favorable safety profile will be especially appealing to general practitioners and primary care physicians, who treat the majority of depression sufferers worldwide." This article was prepared by Drug Week editors from staff and other reports. <> << Copyright ©2002 NewsRx.com >>
02 Декабрь, 2002
Eli Lilly/ New ADHD Medication Strattera Effective in Girls...
Business Editors, Health & Medical Writers INDIANAPOLIS----Dec. 2, 2002--Strattera is effective in treating Attention-Deficit/Hyperactivity Disorder in school-age girls, according to a study published in the December online issue of the journal Pediatrics . Business Wire via NewsEdge Corporation : Business Editors, Health & Medical Writers INDIANAPOLIS--(BUSINESS WIRE)--Dec. 2, 2002--Strattera(tm) (atomoxetine HCl) is effective in treating Attention-Deficit/Hyperactivity Disorder (ADHD) in school-age girls, according to a study published in the December online issue of the journal Pediatrics (Volume 110, Number 6). This study seeks to augment the limited amount of data available on the efficacy of pharmacologic treatments in girls specifically. "This is one of the largest studies of treatment effects of medication in this (school-age girls) population," said John Heiligenstein, M.D., Medical Advisor, Eli Lilly and Company, a study co- author. "The study confirms the efficacy of Strattera in treating ADHD in boys and girls." The lack of information regarding ADHD treatment in girls is likely because many more boys than girls are referred for treatment. Boys have greater rates of more noticeable disruptive behaviors that affect others, often as a result of comorbid oppositional defiant disorder and conduct disorder, which are less common in girls.(1) Core ADHD symptoms seen in girls are similar to those seen in boys.(2) ADHD affects 3-7 percent of school age children(3) and manifests itself in levels of attention, concentration, activity, distractibility, and impulsivity that are inappropriate to the child's age.(4) Experts estimate 60 percent of children with the disorder carry their symptoms into adulthood.(5) The Pediatrics study was a subset analysis of 51 girls (Strattera n=30, placebo n=21) that found Strattera efficacy superior to placebo on all parent and investigator rating scales. The data come from two identical, double-blind, placebo-controlled 9-week clinical trials of 291 children conducted in the United States. Results Patients treated with Strattera experienced a decrease in their ADHD RS Total Score that was statistically significant compared to placebo (15.8 vs 5.8, respectively). Strattera- and placebo- treated patients' ratings on the Inattentive subscale (-8.8 and -3.4, respectively) and Hyperactive/ Inattentive subscale (-7.0 and -2.3, respectively) showed a significant drug effect as well. CPRS-R and CGI-ADHD-S scores also showed significant improvement for Strattera patients. According to the authors, Strattera significantly decreased ADHD signs and symptoms in girls with ADHD. The data reported from this subset analysis addresses an important void in what is known about treatment of school-age girls with ADHD. The study found that Strattera was generally safe and well-tolerated in school-age girls. The most commonly-reported side effects of patients taking Strattera were abdominal pain, rhinitis and headache. Only one patient each from the Strattera and placebo groups discontinued due to an adverse event (chest pain and somnolence, respectively). Study Design The study included 291 children and adolescents, ages 7-13, who met criteria for ADHD as spelled out in the Diagnostic and Statistical Manual for Mental Disorders, 4th edition (DSM-IV). The DSM-IV includes 18 core symptoms of ADHD - nine related to inattention and nine related to hyperactivity and impulsivity. All diagnoses were confirmed through clinical interviews. Exclusion criteria included poor metabolism of the cytochrome P450 2D6 isoenzyme; weight less than 25 kg at the initial visit; a documented history of bipolar I or II disorder or history of psychosis; history of an organic brain disease or a seizure disorder; currently taking psychotropic medication; history of alcohol or drug abuse within the past 3 months; positive screening for drugs of abuse; or significant previous or current medical conditions (e.g., human immunodeficiency virus positive, surgically corrected congenital heart defects, leukemia in remission). After a two-week medication washout period, patients were divided into two groups based on their previous exposure to psychostimulants. Patients never treated with psychostimulants were randomized to double-blind treatment with Strattera, placebo or methylphenidate, while patients with a history of psychostimulant use were randomized to double-blind treatment with Strattera or placebo. The methylphenidate arm of the study was included to validate the study design. The Strattera dose was titrated based on clinical response to a maximum daily dose of 2.0 mg/kg/day. The ADHD Rating Scale-IV-Parent Version: Investigator Administered (ADHD RS), an 18-item scale based on an interview with the patient's primary caretaker was the primary measure of symptom response. Each item on the ADHD RS corresponds to one of the 18 DSM-IV criteria. The ADHD Index subscale of the Conners' Parent Rating Scale-Revised: Short Form (CPRS-R) and the Clinical Global Impressions of Severity of ADHD (CGI-ADHD-S) scales were also used. A limitation of this data is the lack of teacher-rated efficacy measurements. Strattera Strattera is a selective norepinephrine reuptake inhibitor marketed by Eli Lilly and Company (NYSE:LLY) for treatment of ADHD in children, adolescents and adults. Strattera is the only noncontrolled medication approved for the treatment of ADHD. The precise mechanism of action of Strattera is unknown, however, scientists believe it works by selectively blocking the reabsorption of norepinephrine into certain nerve cells in the brain. Norepinephrine is a neurotransmitter, a chemical that moves messages from brain cell to brain cell, and is thought to be important in regulating attention and controlling impulses. Strattera should not be taken at the same time as, or within two weeks of taking, a monoamine oxidase inhibitor, or by patients with narrow angle glaucoma. Patients with a history of high or low blood pressure, increased heart rate, or any heart or blood vessel disease should tell their doctor before taking Strattera. Strattera has not been tested in children less than 6 years of age. Some children may lose weight when starting treatment with Strattera. As with all ADHD medications, growth should be monitored during treatment. Most people in clinical studies who experienced side effects were not bothered enough to stop using Strattera. The most common side effects in children and adolescents were decreased appetite, nausea, vomiting, tiredness and upset stomach. In adults, the most common side effects were problems sleeping, dry mouth, decreased appetite, upset stomach, nausea or vomiting, dizziness, problems urinating, and sexual side effects. Lilly, a leading innovation-driven corporation, is developing a growing portfolio of best-in-class pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations. Headquartered in Indianapolis, Ind., Lilly provides answers - through medicines and information - for some of the world's most urgent medical needs. (1) Biederman J, Newcorn J, Sprich S. Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. Am J Psychiatry. 1991:148:564-577 (2) Biederman J, Faraone SV, Mick E, et al. Clinical correlates of ADHD in females: findings from a large group of girls ascertained from pediatric and psychiatric referral sources. J Am Acad Child Adolesc Psychiatry. 1999;38:966-975 (3) American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision. Washington, DC, American Psychiatric Association, 2000 (4) American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Washington, DC, American Psychiatric Association, 1994. (5) American Psychiatric Association: DSM-IV-TR.2000.85-93 Schweitzer JB, et al. Attention-deficit/hyperactivity disorder. Med Clin of North Am. 2001; 85(3):757-777 --30--slb/cl* CONTACT: Eli Lilly and Company David Shaffer, 317/651-3710 KEYWORD: INDIANA INDUSTRY KEYWORD: MEDICAL PHARMACEUTICAL SOURCE: Eli Lilly and Company Today's News On The Net - Business Wire's full file on the Internet with Hyperlinks to your home page. URL: http://www.businesswire.com BWviaNewsEdge <> << Copyright ©2002 Business Wire >>
30 Ноябрь, 2002
The Irish Times/ Home News/ State urged to take initiative in changing views on schizophrenia
The Government was urged yesterday to take the initiative in changing attitudes by highlighting 'the true facts' about schizophrenia. Europe Intelligence Wire via NewsEdge Corporation : The Government was urged yesterday to take the initiative in changing attitudes by highlighting 'the true facts' about schizophrenia. Mr John Saunders, director of Schizophrenia Ireland, speaking in Kilkenny also said the State, through the health boards, should provide information and education on mental illness. 'Stigma - Breaking Down The Barriers' is the theme of the 13th biennial conference held by Schizophrenia Ireland. 'The truth is that schizophrenia occurs in all societies, at the same rate, regardless of class, colour, religion, culture or intelligence,' Mr Saunders said. One of the myths the conference heard discussed was that people with schizophrenia are violent. 'This myth is exacerbated by the media. People with schizophrenia are no more likely to be violent than any other group in the community,' Mr Saunders claimed. It was also untrue to say that people with the illness could not recover. Schizophrenia as 'a life-long illness is not inevitable, people do improve and recover and hope is regarded as an essential ingredient for recovery,' Mr Saunders pointed out. More than 250 delegates are attending the conference to discuss schizophrenia, which is characterised by disturbances in a person's thoughts, perceptions, emotions and behaviour. It affects one person in every hundred. The seminar was officially opened by Mr Tim O'Malley, Minister of State for Health and Children with special responsibility for disability and mental illness. He said that a history of mental illness should never be a cause of discrimination, stigmatisation or prejudice. Mr O'Malley expressed concern at the prevalence of polypharmacy, simultaneous prescription of a large number of drugs to individual patients in mental hospitals. 'Traditionally, polypharmacy has a negative connotation implying an inappropriate or irrational use of multiple medications,' he said. He envisaged the new Mental Health Commission taking an active part in dealing with the problem. The role of the media in presenting mental illness was the subject of a panel discussion yesterday afternoon with Fintan O'Toole of The Irish Times. Also taking part were Mr Peter Byrne, consultant psychiatrist, and Mr Fergal Bowers, editor of Irish Health.com. The keynote address will be given today by Dr Patrick Corrigan, professor of psychiatry at the University of Chicago, who will speak about various forms of stigma and the basic strategies to change them. Prof Corrigan is the director of the Centre for Psychiatric Rehabilitation, a clinical research and training programme for people with severe mental illness and their families. <> << Copyright ©2002 Financial Times Limited, All Rights Reserved >>
26 Ноябрь, 2002
Use of certain affinity NMDA antagonists as antidepressants (Assignee -- AstraZeneca AB)
Abstract: The invention relates to the use of certain pharmaceutical compounds as antidepressant agents. U.S. Patents via NewsEdge Corporation : Abstract: The invention relates to the use of certain pharmaceutical compounds as antidepressant agents. Ex Claim Text: Method of treating or preventing depression in a mammal which comprises administering to a person in need thereof a therapeutic effective amount of a compound having low affinity NMDA antagonist activity or a pharmaceutically acceptable salt thereof, where the compound is a compound of formula (I): ##STR2## wherein: R.sup.1 is pyridyl, phenyl or 4 fluorophenyl; R.sup.2 is phenyl or 4 flurophenyl; R.sup.3 hydrogen, C.sub.16 alkyl or methoxycarbonyl; R.sup.4 is hydrogen or methyl; and R.sup.5 is hydrogen or COCH.sub.2 NH.sub.2. Patent Number: 6479553 Issue Date: 2002 11 12 If you would like to purchase a copy of this patent, please call MicroPatent at 800-648-6787. Inventor(s): McCarthy, Dennis J. << Copyright ©2002 MicroPatent >>
25 Ноябрь, 2002
Bipolar Disorder - New data suggest Zyprexa superior to lithium for preventing mania relapse
Zyprexa was found to be more effective than lithium in helping patients with bipolar disorder remain in remission and prevent relapse into mania, according to new data presented at the Third European Stanley Foundation Conference on Bipolar Disorder. Pain & Central Nervous System Week via NewsEdge Corporation : Zyprexa was found to be more effective than lithium in helping patients with bipolar disorder remain in remission and prevent relapse into mania, according to new data presented at the Third European Stanley Foundation Conference on Bipolar Disorder. The year-long study showed that in the maintenance treatment of bipolar disorder, patients taking Zyprexa relapsed into mania only half as often as patients taking lithium, which has long been considered a standard of care for stabilizing mood in bipolar disorder. The two treatments were comparable with regard to preventing relapse into depression. In addition, significantly more Zyprexa-treated patients completed the study and significantly fewer were hospitalized. "While both drugs performed well, Zyprexa was found to be superior to lithium. This is especially impressive from a clinical standpoint given that lithium has been the gold standard for decades for the prevention of mania," said Frederick Goodwin, MD, director, Center on Neuroscience, Medical Progress, and Society, George Washington University Medical Center, Washington, DC. "This advance is very encouraging for the long-term treatment of the disease, meanwhile, we must continue our efforts to improve outcomes for bipolar depression." "What we have are two solid treatment options," said Mauricio Tohen, MD, PhD, Lilly Clinical Research Fellow, Lilly Research Laboratories. "This study provides further evidence that Zyprexa as a foundational treatment can help patients maintain dependable control in all phases of bipolar disorder, ultimately helping them to move their lives forward." This article was prepared by Pain & Central Nervous System Week editors from staff and other reports. <> << Copyright ©2002 NewsRx.com >>
25 Ноябрь, 2002
Anorexia - Appetite trigger leptin may be key
Researchers have spotted a likely new reason for bone loss that afflicts women and teenage girls who exercise so much or eat so little that they wind up starving themselves. Health & Medicine Week via NewsEdge Corporation : Researchers have spotted a likely new reason for bone loss that afflicts women and teenage girls who exercise so much or eat so little that they wind up starving themselves. The focus is on the appetite hormone leptin, which is produced by fat cells and influences brain chemistry that regulates appetite. When fat cells are plump, leptin levels are high. When fat cells are lean, leptin levels are low. But scientists believe leptin's role gets more complicated in people who eat far less than they require for normal metabolism. In these cases, the body reduces activities that are not vital, and building bone is among them. Researchers say very low leptin levels prevent bone cells from doing their normal job of building mineral in bone. "The bone goes to sleep," said Dr. Michelle P. Warren of Columbia-Presbyterian Medical Center in New York City. "It's almost a hibernation, to conserve energy." Warren and colleagues at Columbia-Presbyterian reviewed research, including her own, in the October 2002 issue of the Physician and Sportsmedicine. They focused on girls and women whose energy deficit can lead to an exercise-associated amenorrhea - the loss of their regular monthly periods. Over time, women with this condition can lose bone, setting them up for increasingly fragile bones, including osteoporosis, as they age. A low-calorie, high-energy-output imbalance can happen because of the demands of physical activities - thinness is a valued characteristic in gymnasts and ballet dancers, for instance. It also can happen to those with anorexia, the compulsion to be thin. "Low leptin levels have been reported in amenorrheic women who exercise regularly at high levels," the journal said. Previous research had focused on estrogen, which declines in amenorrheic females. That was partly blamed for the shutdown of the reproductive system and loss of bone. The new research indicates it's not so simple. Estrogen and leptin seem to have different ways of doing damage, Warren said. While leptin loss retards new bone building, estrogen loss seems to take the brakes off other cells, called osteoclasts, which strip out old bone mineral, Warren said. The result would be double the bone vulnerability - growth is inhibited and loss is accelerated. Exercising this much also reverses what would otherwise be a healthy trend. "Physical activity is important in maintaining bone mass; however, many women tend to exercise excessively, causing hormonal changes that predispose them to an increased risk of fractures," the authors said. Warren said the leptin link is worthy of further study. But scientists say there is no sign now that leptin supplements would solve the bone-loss problem. Warren said the idea sounds promising but research to show it would spur new bone growth has not been done. In addition, the supplement might harm appetite in people who have calorie- balance problems, she said. It's also too soon for doctors to use leptin levels as an early warning sign of inadequate bone mass, said Dr. Carol Otis of Kerlan-Jobe Orthopaedic Clinic in Los Angeles, who did not work on the review article. Leptin is more properly "a marker of inadequate nutrition and weight loss," she said. And even use of low leptin levels as an indicator of calorie-balance problems could be misleading, Otis said. Leptin levels vary during the day, so several blood samples would be required, and normal reference levels of leptin in the blood have not been determined, she said. This article was prepared by Health & Medicine Week editors from staff and other reports. <> << Copyright ©2002 NewsRx.com >>
23 Ноябрь, 2002
Cannabis timebomb
TEENAGE cannabis- smokers dramatically increase their risk of suffering mental illness, doctors reveal today. Europe Intelligence Wire via NewsEdge Corporation : TEENAGE cannabis- smokers dramatically increase their risk of suffering mental illness, doctors reveal today. Youngsters face being struck by depression and schizophrenia in later life, according to three studies which back mounting evidence of the damaging effects of the drug. Researchers discovered that those who started using cannabis in their teens had a fourfold higher risk of being diagnosed with a psychiatric disorder, and the severity was linked to how long they had taken the drug. The findings, published in the British Medical Journal, show that the risks to mental health of the so-called 'soft' drug are far higher than previously thought. At least a third of UK youngsters have tried the drug, figures from the European School Survey of 15 and 16-year-olds show. Another report found that 79 per cent of children believe cannabis is 'safe'. The research on the health effects of the drug will shock many from a previous generation who for more than 30 years have claimed it is harmless. A study at King's College, London, led by Dr Louise Arsenault, proved for the first time that schizophrenia - characterised by delusions and hallucinations - can be triggered by using cannabis. The research followed 759 people in New Zealand from their birth in 1972 until the age of 26 in 1998. It found that young adolescents who used cannabis, especially those who started before they were 15, had more symptoms of schizophrenia as adults than nonusers. Those who began using the drug in their early teens were four times more at risk of developing serious psychiatric condition than nonusers. One in ten who used cannabis before the age of 15 developed schizophrenia by the age of 26 compared to three per cent of those who did not. Dr Arsenault said: 'The uniqueness of this study is that we could identify symptoms children had before they started using cannabis. 'As a result, we can say that cannabis can trigger schizophrenia rather than the drug being chosen by people predisposed to develop this illness. 'At the very least, cannabis use should be delayed until late teens. It is only in the 1990s that very young teenagers began using it, and we may find schizophrenia increasing in the next few years. 'Young people think cannabis is a cool and safe drug, but it's very dangerous.' In the second study, experts at Murdoch Children's Research Institute in Victoria, Australia, found that teenage girls who frequently used the drug were more likely to suffer depression and anxiety than other adolescents. Daily use of cannabis was linked to a more than fivefold increase in the risk, while weekly use resulted in a doubling of risk, said the study of 1,600 students. The third study, of more than 50,000 Swedish men, showed the use of cannabis increased the risk of schizophrenia by 30 per cent. The findings led to calls from the Royal College of Psychiatrists for the Government to halt moves which would effectively decriminalise cannabis use. Professor Drummond, a leading psychiatrist at St George's Hospital Medical School, London, and a member of the college's substance misuse faculty, said a relaxation of the law would lead to more young people using the drug and higher rates of mental illness. 'We need a major Government campaign to tell people about the risks of using cannabis,' said Professor Drummond. 'It must also invest in treating cannabis dependence, because more people are turning up at NHS addiction clinics with this problem. Police in South London have been running an 'experiment' in toleration of cannabis, which no longer leads to the automatic arrest of users. 'Experiments like Brixton send out the message that cannabis is a safe drug because the police think so,' said the professor. 'But research shows the dangers.' Doctors do not understand how cannabis increases the risk of mental illness, but suspect it affects production of the brain chemical dopamine. Marjorie Wallace, chief executive of mental health charity Sane, said, 'Research is increasingly confirming our concerns about the use of cannabis and its relation to mental illness.' <> << Copyright ©2002 Financial Times Limited, All Rights Reserved >>
05 Ноябрь, 2002
Early treatment of schizophrenia with atypical antipsychotics may improve outcome
Cannon TD, Huttunen MO, Dahlstr?m M et al. Antipsychotic drug treatment in the prodromal phase of schizophrenia. Am J Psychiatry 2002:159:1230 - 2. Early drug treatment gives a better long-term outcome for patients with schizophrenia, possibly because it slows deterioration. This Finnish, multicentre, open-label trial showed that starting a low-dose atypical antipsychotic (risperidone) early improved thought and behaviour disturbances in prodromal and first-episode patients. Four prodromal high-risk adolescents (15 - 20 years) and six first-episode patients (16 - 35 years) were treated with average doses of 1.0 and 1.8mg/day respectively, for up to 12 weeks. The maximum daily dose was 2mg/day and 4mg/day for prodromal and first-episode patients, respectively, although this could be titrated downwards. Neurocognitive measures and symptom ratings were taken at baseline and two follow-ups. They were assessed by the California Verbal Learning Test (CVLT; all subject) the Child Behaviour Checklist (CBC; prodromal) and the Positive and Negative Syndrome Scale (PANSS; first episode). On average, both groups significantly improved on the CVLT, and on their respective symptom measures (CBC and PANSS). There were minor adverse events (tremor/tic, exhaustion/anxiety, sedation, dystonia, dry mouth/rhinitis) in five subjects, but these resolved. This study was limited by the small group size, the lack of a placebo control group, and failure to control for practice effects on the neurocognitive tests. Nevertheless, all patients had consistent, statistically significant improvements. The authors concluded it was worth doing a more thorough clinical trial.
04 Ноябрь, 2002
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