[Metabolic risk during antipsychotic treatment in patients with schizophrenia]. / Zaburzenia metaboliczne zwiazane ze stosowaniem leków przeciwpsychotycznych u chorych na schizofrenie.

Compared with the general population, persons with schizophrenia are characterized with an increased prevalence of obesity, type 2 diabetes mellitus, and cardiovascular disease. Weight gain and increased adiposity is associated with decreases in insulin sensitivity, leading to an increased risk of hyperglycaemia and hyperlipidemia. Antipsychotic drugs can increase adiposity and the range of trials suggests that treatment with antipsychotic medications may be associated with an increased risk of acute (ketoacidosis), subacute (weight gain, glucose intolerance, insulin resistance, dyslipidemia), and chronic (diabetes, hypertension, coronary heart disease) metabolic complications. Conclusions regarding the relative effects of various antipsychotic agents on different components of the metabolic syndrome were reviewed, as well as recommendations for monitoring these effects were noted. Selection and management of the antipsychotic agent reflects a balance between optimizing therapeutic effectiveness, modifying diet and exercise, and avoiding excessive weight gain, dyslipidemia, and insulin resistance.

[Effectiveness and tolerability of amisulpride in patients with schizophrenia: results of a 6-month open study]. / Ocena skutecznosci i tolerancji amisulpridu u pacjentów ze schizofrenia: wyniki 6-miesiecznego otwartego badania klinicznego.

AIM: 6-month multicentre, observational, open study evaluated the efficacy and tolerability of the new generation antipsychotic drug amisulpride in patients with acute schizophrenia. METHOD: 99 patients were included in the study, 72 (72%) completed the 6-month observation. RESULTS: Marked improvement in CGI after 6 months of treatment was observed in 56 (56%) patients. Therapy with amisulpride reduced both positive (20% reduction of positive symptoms in the PANSS positive subscale in 78%) and negative symptoms (20% reduction of negative symptoms in the PANSS negative subscale in 77%). CONCLUSION: Amisulpride was well tolerated, adverse events responsible for premature withdrawal from the study were observed only in 6% patients.

Validity and reliability of the Polish version of the Positive and Negative Syndrome Scale (PANSS).

This study presents the results of a training course on using the Positive and Negative Syndrome Scale (PANSS) for the assessment of mental status. The agreements between ratings produced by 418 physicians (psychiatrists) were evaluated and compared with standard ratings. In this way it was possible to supplement some of the listed symptoms with comments, which may help to increase agreement between results obtained through raters' assessments and standard ratings.

Drug maintenance treatment compliance and its correlation with the clinical picture and course of schizophrenia.

The relationship between patients compliance with their drug therapy regime and important predictors of schizophrenia was studied on the basis of a 7-year observation (from the onset of illness) of 185 schizophrenic patients. Compliant patients (N= 57) were compared with noncompliant patients (N=37). The two groups were matched for age at onset, sex, social background and presence of precipitating factors. The compliant patients had better occupational and family adjustment, less intense behaviour disorders prior to the onset of schizophrenia, a shorter term of untreated first psychosis. These patients also had shorter periods of untreated relapses and longer remissions. They had more often insight of their disease whereas serious signs of defect were less frequent. They had later onset of disturbances of self-activity, vitality and identity. The results of this study suggest that with compliance with a neuroleptics drug treatment regime does not affect the number of admissions in the hospital but is related to longer remissions and less intense signs of deficiency.

[Valproate in the treatment of bipolar disorder]. / Kwas walproinowy w leczeniu zaburzen afektywnych dwubiegunowych.

The paper presents the views on the use of valproate and its' derivatives in the treatment of mania and in the prophylactics of recurring bipolar affective disorder. The anti manic use of valproate has been confirmed in about half of those treated. Monotherapy of manic states with valproate brings about good results less frequently than with the use of lithium or neuroleptics. However in the treatment of mania, valproate is suggested equally frequent as lithium and carbamazepine, especially in the USA. This particularly concerns those ill in nonacute mania, mixed manic-depressive states, rapid cycling of manic as well as depressive phases--in these cases the results of treatment with valproate are best. Also in those where treatment with lithium proved ineffective, the addition of valproate can be of benefit. Valproate is also useful in the combined treatment with a neuroleptic. In the prevention of recurrence of bipolar affective disorder, the use of valproate seem to be not only equally effective as lithium, but also beneficial due to its' better tolerance. For the final outcome of the effectiveness of valproate in inhibiting recurrence, a study which would last longer than one year, would appear necessary. Further studies are also necessary in order to confirm the effectiveness of valproate in schizoaffective psychoses, manic patients addicted to medications or alcohol, organic disorders of the CNS, or the elderly patients. The more precise description of doses and the therapeutic concentration of the drug in the bloodstream in correlation with its' anti-manic and anti-recurrence action, seems to be necessary.