RESUMO
OBJECTIVES: This study aimed to compare psychomotor performance related with automobile driving in patients with schizophrenia under the treatment of a typical antipsychotic agent, haloperidol, or an atypical antipsychotic agent, aripiprazole. METHODS: We evaluated driving ability of schizophrenia patients by using the cognitive perceptual assessment for driving (CPAD). Twelve patients receiving haloperidol monotherapy and 18 taking aripiprazole monotherapy participated in this study and the results of CPAD were compared with each other. RESULTS: Of 30 participants, 15 (50%) of the patients passed the CPAD to be regarded as competent to drive, 3 (10%) of the patients failed the CPAD considered to be severely impaired. Controlling for sex, age, education, duration of illness, there were no significant differences in the CPAD results between two treatment groups. We observed a trend that patients who received aripiprazole showed a higher total score of the CPAD than haloperidol-treated patients (55.2+/-4.9 vs. 45.7+/-8.4, p=0.080). CONCLUSION: There were no significant differences in the psychomotor performance relevant to driving ability between haloperidol and aripiprazole groups. But our results suggest that aripiprazole might have the neurocognitive advantage over haloperidol. Future study with a large sample size and diverse antipsychotics is warranted.
Assuntos
Humanos , Antipsicóticos , Condução de Veículo , Haloperidol , Imidazóis , Nitrocompostos , Piperazinas , Desempenho Psicomotor , Quinolonas , Tamanho da Amostra , Esquizofrenia , AripiprazolRESUMO
Skin rash is one of the most common drug-induced side effects. Most of the lesions are usually self-limited and subsided by quitting causal drugs. However, generally, prescriptions involve intake of various drugs, so it is not easy to establish the cause. We report two cases of the patients who had experienced the skin rash in their first manic episode of bipolar I disorder while taking valproate and quetiapine. Their lesions had clearly subsided after quetiapine and valproate were stopped. In clinical practice, polypharmacy is an effective treatment strategy of bipolar disorder. Thus in case of prescribing various drugs, the close observation of drug-induced side effects is needed and drug interaction should be kept in mind.
Assuntos
Humanos , Transtorno Bipolar , Dibenzotiazepinas , Interações Medicamentosas , Exantema , Polimedicação , Prescrições , Pele , Ácido Valproico , Fumarato de QuetiapinaRESUMO
OBJECTIVE: Genetic variation in the serotonin-2C receptor encoded by the HTR2C gene is one of the genetic determinants of antipsychotic-induced weight gain. Peroxisome proliferator-activated receptors are nuclear receptors regulating the expression of genes involved in lipid and glucose metabolism. In this cross-sectional study, we investigated whether HTR2C-759C/T, HTR2C-697G/C, PPARalpha V227A, and PPARgamma 161C/T genotypes were associated with metabolic syndrome (MetS) in patients with schizophrenia taking clozapine. METHODS: One hundred forty-six Korean patients using clozapine for more than one year were genotyped for the HTR2C-759C/T, HTR2C-697G/C, PPARalpha V227A, and PPARgamma 161C/T polymorphisms, and their weight, waist circumference, blood pressure, triglycerides, high-density lipoprotein-cholesterol, total cholesterol, and glucose were measured. We used the criteria for MetS proposed by the National Cholesterol Education Program-adapted Adult Treatment Panel III. RESULTS: The prevalence of MetS was 47.3% and was similar among men (49%) and women (42.9%). We found no significant differences between patients with and without MetS in terms of genotypes or allele frequencies. Logistic regression analyses also revealed no association between MetS and each genotype. CONCLUSION: We did not find significant associations between four polymorphisms (HTR2C-759C/T, HTR2C-697G/C, PPARalpha V227A, and PPARgamma 161C/T) and MetS in patients with schizophrenia taking clozapine.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pressão Sanguínea , Colesterol , Clozapina , Estudos Transversais , Frequência do Gene , Variação Genética , Genótipo , Glucose , Modelos Logísticos , Receptores Ativados por Proliferador de Peroxissomo , Peroxissomos , Polimorfismo Genético , PPAR alfa , PPAR gama , Prevalência , Receptores Citoplasmáticos e Nucleares , Esquizofrenia , Triglicerídeos , Circunferência da Cintura , Aumento de PesoRESUMO
The novel antipsychotic, olanzapine, has structural and pharmacological properties similar to clozaine. Antipsychotic drugs, as well as mood stabilizers, can cause neutropenia, which can progress to life-threatening agranulocytosis if the medication is not discontinued. We report two cases of reversible neutropenia associated with a olanzapine-valproate combination treatment. This report suggests that patients treated with the combination of olanzapine and valproate should be monitored for the occurrence of leukopenia and neutropenia.
Assuntos
Humanos , Agranulocitose , Antipsicóticos , Benzodiazepinas , Leucopenia , Neutropenia , Ácido ValproicoRESUMO
OBJECTIVES: We have aimed to estimate the direct and indirect costs of treating out-patients with schizophrenia in Korea, to use this fundamental data for the effective management and proper distribution of the medical resource. METHOD: To estimate the direct cost, we surveyed the medical cost and time of two hundred and eighty-nine out-patients with schizophrenia for six months. And the lost productivity as many months was converted into the indirect cost. Those of eighty-two coronary heart disease patients were also estimated as a comparison group. RESULTS: An unemployement rate of schizophrenic patients was 72.1 percent. Moreover the ratio of the laborer in the sample was, even if employed, 64.5 percent. The mean direct cost of schizo-phrenic patients was, about 815,000 won, higher than that of coronary heart disease, 715,000 won however it was not statistically significant. The former was also estimated 2.5 times more than the latter for the indirect cost, or 6,456, 000 won versus 2,589,000 won. CONCLUSION: Schizophrenia is a relatively costly illness compared to other chronic illness, so the systematic estimation of the cost is necessary to provide mental health service of high quality.