RESUMO
BACKGROUND: One of the major causes of death in schizophrenia is a metabolic syndrome. The clozapine has the highest rate of weight gain among antipsychotics. It has been shown that metformin can promote weight loss. We aimed to investigate the effect of metformin as an adjunctive therapy with clozapine to prevent metabolic syndrome in patients with schizophrenia. MATERIALS AND METHODS: A total of 37 patients consisting metformin group (19 cases) and a group of placebo consisting of 18 cases were evaluated. A brief psychiatric rating scale score (BPRS) and metabolic profiles was determined for all patients. All of the variables were also determined at 2, 8, 16, and 20 weeks after the onset of the study. RESULTS: The mean age of the group of metformin was 47.2 ± 10.4 compared with 45.8 ± 10.2 for the group of placebo. The difference in mean waist circumference and serum level of triglyceride at baseline compared with the end of study showed a statistically significant difference between two groups (P = 0. 000). A statistically significant difference was also observed in a comparison of mean difference of weight and body mass index at baseline compared with end of study (P = 0. 000). There was a statistically significant difference of fasting blood sugar (P = 0.011) and serum high-density lipoprotein (P = 0.000) between two groups but this difference was not significant for mean BPRS scores, mean systolic and diastolic blood pressure, serum level of triiodothyronine, thyroxin and thyroid stimulating hormone, serum low-density lipoprotein and serum cholesterol. CONCLUSION: Metformin could be considered an adjunctive therapy with clozapine to prevent metabolic syndrome in schizophrenic patients.
RESUMO
BACKGROUND: Second-generation antipsychotics, approved for the treatment of mania, are associated with adverse effects such as weight gain and metabolic disorders. Aripiprazole, a recently introduced second-generation antipsychotic, are thought to account for its low propensity for weight gain, metabolic disturbances and sedation. The purpose of this study was to investigate the effect of risperidone versus aripiprazole in the treatment of acute mania. MATERIALS AND METHODS: Fifty patients with acute episodes of mania were enrolled in this study, and they were randomly assigned into a risperidone group of 24 cases and an aripiprazole group of 26 cases. In group A, aripiprazole with a dose of 5-30 mg/day and in group B, risperidone with a dose of 2-8 mg/day was given to patients. The average dose of aripiprazole was 27 mg/day, and the average dose of risperidone was 6 mg/day. The effects of each drug for the treatment of acute mania were assessed on the 1(st) day of admission and on days 2, 4, 6, 8 and at weeks 2, 4 and 6 after therapy using the young mania rating scale (YMRS) and at the baseline and on weeks 3 and 6 after admission using the clinical global impression (CGI) scale. RESULTS: The mean age of the group of risperidone was 34 ± 8.6 years and in a group of aripiprazole it was 34 ± 9.1 years (P = 0.83). Comparison of YMRS scores over the period of 6 weeks revealed a statistically significant difference in both groups (P < 0.0001). There was also a statistically significant difference in YMRS scores between risperidone and aripiprazole at day 8 (P = 0.026) and weeks 2 (P = 0.035) and 4 (P = 0.042). There was also a statistically significant difference in CGI-Severity scale score at weeks 3 (P = 0.003) and 6 (P = 0.000) and in CGI-Improvement scale score at weeks 3 (P = 0.005) and 6 (P = 0.002). The most common side-effect observed in both groups was headache (0%15/4 in aripiprazole vs. %16/7 in risperidone). CONCLUSION: Aripiprazole that is readily available in our market, could be considered more effective than risperidone in the treatment of acute mania.
RESUMO
BACKGROUND: Obsessive compulsive disorder has been reported in patients with multiple sclerosis (MS). Obsessive compulsive disorder (OCD) is a kind of anxiety disorder characterized by a combination of repetitive thoughts and repetitive behaviors for reducing anxiety. We aimed to investigate the frequency of OCD in patients with MS. MATERIALS AND METHODS: 112 patients with multiple sclerosis participated in this study. Demographic data were obtained through using patients' medical records. MS clinical subtypes, the duration of disease and neurological signs were determined. The Kurtzke Expanded Disability Status Scale (EDSS) was used to quantify disability in MS, which was confirmed by psychiatrist through using DSM-IV criteria for OCD. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was used to rate the severity of OCD. Data analysis was performed by SPSS for Windows software (version 15.0) and Chi-square test and Exact test were used for analyzing data. RESULTS: The frequency of OCD in patients with MS was 16.1%. The OCD was significantly correlated with a higher EDSS score (X(2) = 86.515, P = 0.0001). OCD was also significantly correlated with the duration of disease, phenotypic subgroup, cranial nerve involvement, cerebellar, autonomic, sensory and motor nerve involvement. CONCLUSIONS: OCD might be considered in quantifying disability of patients with MS. It might be suggested that all the patients with MS to be screened for OCD.