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OBJECTIVE:To compare clinical efficacy and safety of olanzapine and quetiapine for mental disorders elderly pa-tients. METHODS:120 elderly patients with mental disorders were randomly divided into olanzapine group and quetiapine group, with 60 cases in each group. Olanzapine group was given Olanzapine tablet orally with initial dose of 2.5 mg,qd,and then increas-ing to maximal dose 15 mg according to disease condition,qd;quetiapine group was given Quetiapine tablet orally with initial dose of 50 mg,qd,increasing to maximal dose 400 mg according to disease condtion,qd. Both groups received 6 weeks of treat-ment. Clinical efficacy of 2 groups were compared as well as PANSS and the quality score of life before and after treatment,and the occurrence of ADR. RESULTS:PANSS and the quality score of life were improved significantly in both groups,with statisti-cal significance (P>0.05);but there was no statistical significance between 2 groups (P>0.05). There was no statistical signifi-cance in clinical efficacy between 2 groups(P>0.05). The incidence of lethargy,hypotension and bradycardia in quetiapine group were significantly lower than in olanzapine group,while the incidence of tachycardia was significantly higher than olanzapine group,with statistical significance (P<0.05). CONCLUSIONS:Olanzapine and quetiapine are similar to each other in the treat-ment of mental disorders elderly patients;both of them can effectively improve the quality of life,and ADR induced by quetiapine is slighter than that induced by olanzapine.
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Objective To explore the status of oxidative stress (OS) in the first-episode schizophrenia patients (FEP) and to examine the effects of antipsychotic drugs on oxidative stress of FEP. Methods The plasma total superox?ide dismutase (T-SOD), glutathione peroxidase (GSH-Px), catalase (CAT) and total antioxidant capacity (T-AOC) were measured in forty-seven FEP (case group) and forty-three healthy volunteers (control group) before and after treatment. Eighteen cases completed 6-week treatment with risperidone (risperidone group) and twenty-five cases completed 6-week treatment with olanzapine (olanzapine group). Results The activity of T-SOD and GSH-Px were lower (P0.05) in FEP compared to the control group. Risperidone and olanzapine significantly improved T-SOD and T-AOC, respectively (P0.05). Conclusion FEP has alterations of antioxidant enzymes, which may be related to the pathogenesis of schizo?phrenia. Antipsychotics risperidone and olanzapine may improve the oxidative stress in FEP.
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Objective To explore neurobiological mechanisms of the withdrawal-induced aversion,the changes of protein kinase A(PKA) were measured in shell of accumbens nucleus (AcbSH) of CPA model rats.Methods 1.All 36 male SD rats were divided into three groups,model group ( MN group),and control group (MS group and SN group).MN group was injected with morphine,6.5 days,10mg/kg,intraperitoneally (IP),twice per day,naloxone injection,0.3 mg/kg,ip,along with conditioned place aversion training,to develop the CPA model.The MS group was administrated equivalent volume of morphine and saline.Also the SN group was injected with equivalent volume of saline and naloxone.2.During the development of CPA,the expression of protein kinase A was assayed with immunohistochemistry in the AcbSH.Results Before the development of CPA,PKA expressions were no significant differences among the three groups in the AcbSH (F=2.306,P=0.130).However,after development of CPA,PKA expressions showed significant differences among the three groups(F =36.516,P =0.000).The average gray intensity of MN group (109.50 ± 4.661 ) was apparently higher than the MS group (126.50 ±3.697,P＜0.01),than the SN group (133.50 ±6.364,P＜0.01).Conclusions 1.Protein kinase A expression,leading to the aversion in the AcbSH probably is a key pathway contributing to the development of CPA.2.The neuroadaptation mediated by PKA may be one of important molecular underpinnings of CPA.
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Objective To investigate whether the 5-hydroxytryptamine 2A receptor (5-HT2A)gene T102 C polymorphism is associated with the severity symptoms and negative symptoms in the first episode Chinese Han nationality patients with schizophrenia. Methods Altogether 201 first episode Chinese Han nationality patients with schizophrenia were enrolled in this study. Genotyping of 5-HT2A gene T102 C polymorphism was performed by PCR-RFLP technique. The positive and negative Symptom Scale ( PANSS ) was used for the evaluation of the severity of psychotic symptoms before any drug treat-ment. Results 5-HT2A receptor 102-T/T genotype was significantly associated with both the PANSS total and negative symptom subscale baseline scores before the treatment, but not with the positive and general psychopathology subscales. Conclusion 5-HT2A T102 C functional polymorphism may play a role in negative symptoms and prognosis of Chinese Han nationality people with schizophrenia.
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BACKGROUND: Interleukin-6 (IL-6) is a cytokine produced in the process of organic immune activities. The problems still need further exploration, including whether the changes of serum level of IL-6 after clozapine treatment ware induced directly by the drug, and whether IL-6 is directly correlated with the changes of the psychiatric symptoms in female patients.with first-episode schizophrenia.OBJECTIVE: To explore the changes of the serum level of IL-6 and its relation with the dose of clozapine and the amelioration of the symptoms in female patients with first-episode schizophrenia.DESIGN: A non-randomized case-control observation synchronically.SETTING: Department of Psychiatry, Second Affiliated Hospital of Xinxiang Medical College.PARTICIPANTS: Twenty female patients with first-episode schizophrenia (patient group) were selected from Henan Psychiatric Hospital. They all met the diagnostic standards of schizophrenia in the 3rd edition of Chinese Classification and diagnostic criteria of Mental Disorders (CCMD-3), their score of positive and negative syndrome scale (PANSS)was above 60 points, and had not been treated or at least not taking medicine for 2 weeks during clinical treatment.Patients with physical disease, endocrine and immune system diseases, malnutrition and other mental problems, those with the history of being allergic and hormone treatment, those receiving immune pharmaceutical treatment, and recently having been vaccinated preventively, and the pregnant and breast-feeding women were excluded. Twenty healthy female volunteers, who had no significnat difference in age and gender from the subjects in the patient group,were taken as the control group, and the exclusive standards were the same as those in the patient group. All the subjects were enrolled with the approval of themselves and their guardians.METHODS: All the patients were adminsitrated with clozapine only, with the dose being added by 25-50 mg per day,and the maximal dose was reached within 3 weeks. The principle for the administration was the maximal effectiveness and the minimal side effect. ① Serum level of IL-6 in the patient group was detected using enzyme-linked immunoabsorbent assay (ELISA) before treatment and at 1, 2 and 4 weeks after treatment respectively. ② High performance liquid chromatography (HPLC) was used to determine the content of clozapine, and the levels of IL-6 in serum of the controls were taken as controls. ③ Correlations were analyzed in the patient group between the serum level of IL-6 before treatment and at 1, 2 and 4 weeks after treatment and the PANSS scores (scores of positive and negative symptoms, and general pathology, and the total score) at corresponding time points.MATN OUTCOME MEASURES: ① Serum levels of IL-6 before treatment and at each time point after treatment; ②Correlation analysis between the serum levels of IL-6 and clozapine content; ③ Correlation analysis between changes of schizophrenic symptoms and serum levels of IL-6.RESULTS: ① Serum level of IL-6 before treatment in the patient group was significantly higher than that in the control group [(137.72±18.84), (65.05±20.95) ng/L, t =11.53, P ＜ 0.01], those in the patient group at 1, 2 and 4 weeks after treatment were significantly lower than that in the control group [(28.11±5.42), (8.48±1.14), (13.90±2.55), (65.05±20.95) ng/L, t =7.63, 12.01, 10.84, P ＜ 0.01]. ② Correlation analysis between the serum levels of IL-6 and clozapine content: The results showed that the serum level of IL-6 had no significant correlation with the clozapine content at 1, 2and 4 weeks after treatment (r =-0.15, 0.12, -0.29, P ＞ 0.05). ③ Correlation analysis between IL-6 level and schizophrenic symptoms: In the patient group, there was significant positive correlation before treatment between the serum level of IL-6 and the score of positive symptoms (r=0.386, P＜ 0.01), and there was no significant correlation between the serum level of IL-6 and the total scores of PANSS and each factor scores at 1, 2 and 4 weeks after treatment (r=0.136-0.237, P ＞ 0.05).CONCLUSION: The serum level of IL-6 in female patients with first-episode schizophrenia was higher than that in healthy females, and it could be decreased by clozapine, and the amelioration of the schizophrenic symptoms had no significant correlation with the changes of IL-6 levels.
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Background 5-hydroxytryptamine 2A receptor (5-HT2A) gene has been regarded as a candidate gene for susceptibility to schizophrenia. In particular, the 5-HT2A receptor has received much attention because it demonstrates to be an important site of action of atypical antipsychotic agents to alleviate negative symptoms. The current study investigated whether the 5-hydroxytryptamine 2A receptor (5-HT2A) gene T102C polymorphism was associated with treatment response to risperidone in the first episode Chinese patients with schizophrenia.Methods 201 first episode Chinese Han patients with schizophrenia were given risperidone for up to 56 days.Genotyping of 5-HT2A gene T102C polymorphism were performed by using PCR-RFLP. The Positive and Negative Symptom Scale (PANSS) was used for the evaluation of the severity of psychotic symptoms before and after 8 weeks treatment with risperidone.Results 5-HT2A receptor 102 -T/T genotype was significantly associated with both the PANSS total and negative syndrome subscale scores before treatment, and with the reduction rates in both the PANSS total and negative syndrome subscale scores after eight weeks risperidone treatment.Conclusions The results suggest that 5-HT2A T102C A/A1 genotype subgroup influences individual response to risperidone in first-episode Chinese patients with schizophrenia.
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BACKGROUND:Schizophrenia is a kind of psychosis which pathogenesis is unknown yet, and its pathogenesis is a key study theme all over the world. Recently it is concerned in genetic study, particularly in the molecular genetics. Among them, it shows a good prospect in researching the candidate functional gene. OBJECTIVE:To analyze the association between the T102C polymorphism of serotonin 2A (5-HT2A) receptor and schizophrenia. DESIGN: A diagnosis-based ease observation and association analysis. SETTING: Second Affiliated Hospital, Xinxiang Medical College and the 13 Branch of General Hospital of Zhongyuan Oil Field. PARTICIPANTS: In the patient group, there were 56 cases of schizophrenie probands, who were hospitalized in the Second Affiliated Hospital of Xinxiang Medical College from August 2003 to April 2004, and their healthy parents (n=112) were also enrolled as the parents group. METHODS:The nuclear family consisted of 56 probands, who met the diagnostic criteria of the third edition of Chinese Classification and diagnostic criteria of Mental Disorders (CCMD-3), and their parents were detected with polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP), the genotype and the T102C polymorphism of schizophrenic 5-HT2A receptor were detected with transmission disequilibrium test (TDT). MAIN OUTCOME MEASURES:The results of allele and genotypic frequency, and the goodness-of-fit for Hardy-Weinberg equilibrium of 5- HT2A receptor, as well as the TDT analytical results of 5-HT2A receptor gene, were observed. RESULTS:All the 56 patients and the 112 parents were involved in the analysis of results. ①No significant differences were found between the patient group and parents group in the genotypic frequencies (χ2 =4.423, P=0.110) and allele distribution (χ2=1.147, P=0.563), and there was a good goodness-of-fit for Hardy-Weinberg equilibrium. ② In the 56 families, the transmission disequilibrium of 39 nuclear families with paternal or maternal genotype of heterozygote detected by TDT showed no association between schizophrenia and 5-TH2A receptor gene (χ2=2.703, P=-0.10).CONCLUSION: There is no association between the 5-TH2A receptor gene T102C and schizophrenia in Chinese Han population.