Sunday, December 31, 2006

Schizophrenia and Psychosis - Early Intervention

Early Intervention in Schizophrenia: What You and Your Family Should Know.

This 32 minute video covers the common questions that families have when a person is showing early signs of psychosis or schizophrenia and they begin treatment. Additionally, a young man describes the first symptoms that he experienced when he began to experience psychosis.

This video was produced in 2004 by the Maine Medical Center PIER program - for more information go to: www.preventmentalillness.org and for more information on schizophrenia visit www.schizophrenia.com.

Saturday, December 30, 2006

Best of 2006

NAMI's picks for the best books and movies of the year. For example:

Divided Minds: Twin Sisters and Their Journey Through Schizophrenia, by Pamela Spiro Wagner and Carolyn S. Spiro, M.D.; New York, St. Martin's Press, 2005, 318 pages, $24.95.


Thursday, December 28, 2006

FDA Approves New Drug for Schizophrenia



In a December 20, 2006, news release the United States Food and Drug Administration writes:

The Food and Drug Administration (FDA) today approved Invega (paliperidone) extended-release tablets for the treatment of schizophrenia. Paliperidone is a new molecular entity, which means this medication contains an active substance that has never before been approved for marketing in any form in the United States. Paliperidone is the principal active metabolite of risperidone, a marketed drug for treating schizophrenia.

"Schizophrenia can be a devastating illness requiring lifelong medication and professional counseling," said Douglas Throckmorton, MD, Deputy Director of FDA's Center for Drug Evaluation and Research. "Today's approval adds to the treatment options for patients with this condition."

Schizophrenia is a chronic, disabling mental disorder that affects more than two million Americans. Symptoms include hallucinations, delusions, disordered thinking, movement disorders, social withdrawal and cognitive deficits (e.g., difficulty with perception, memory or abstract thinking that interferes with one's ability to learn; impaired judgment, inattentiveness, impulsiveness or impairment of speech and language).

The effectiveness of Invega in the acute treatment of schizophrenia was established in three 6-week, placebo-controlled trials conducted in North America, Europe and Asia. The 1665 participating adults were evaluated for the full array of signs and symptoms of schizophrenia. In the three studies using doses ranging from three milligrams (mg) to 15 mg a day, the effectiveness of Invega at relieving symptoms of schizophrenia was superior to the placebo treatment. The recommended dose range for Invega is three mg to 12 mg a day.

Among the commonly reported adverse events were restlessness, extrapyramidal symptoms (movement disorders), rapid heart beat and sleepiness. Invega is a member of a class of drugs called atypical antipsychotics that have an increased rate of death compared with placebo in elderly patients with dementia-related psychosis. Invega is not approved for dementia-related psychosis.

The effectiveness of Invega has not been evaluated in placebo-controlled trials for longer than six weeks, and patients who use the drug for extended periods should be periodically reevaluated by a physician.

Invega is manufactured by ALZA Corp. in Mountain View, CA. for Janssen, L.P. in Titusville, NJ.

Tuesday, December 26, 2006

The Ecotrienes: New Hope for an Old Problem

Daniel J. Luchins, M.D., writes in the October 2006 issue of Psychiatric Services:
The ecotrienes (eco= environment, trienes=prostaglandin-like cellular modulators) were originally isolated from hibernating Norwegian voles. Subsequent animal and human studies have demonstrated that this class of peptides allows mammals to withstand climatic extremes and caloric deprivation. Controlled clinical trials among homeless patients with schizophrenia have consistently demonstrated that the ecotrienes are associated with a marked reduction in hospital and jail recidivism. Despite the high cost of these medications (U.S. $9,000 per annum), pharmacoeconomic analyses suggest savings through reduced use of postdischarge resources, such as food and housing, and also shorter index hospitalizations through elimination of discharge planning.
(Could this to be true?)

Wednesday, December 13, 2006

Non-profit sector accounts for billions in economy: study

CBC.ca reports on recent study published by Statistics Canada:
The GDP of the core non-profit sector reached $29.1 billion in 2003, representing 2.6 per cent of the total economy. The entire non-profit share rose to 7.1 per cent when the GDP of hospitals, universities and colleges was included in the total.

[...]

Even the smaller core sector was about twice the size of the agricultural industry and larger than the accommodation and food services industry in Canada.

Wednesday, December 6, 2006

Randomized Comparison of Olanzapine Versus Risperidone for the Treatment of First-Episode Schizophrenia: 4-Month Outcomes

A recent article published by the American Journal of Psychiatry:

The authors compared 4-month treatment outcomes for olanzapine versus risperidone in patients with first-episode schizophrenia spectrum disorders.

Clinical outcomes with risperidone were equal to those with olanzapine, and response may be more stable. Olanzapine may have an advantage for motor side effects. Both medications caused substantial rapid weight gain, but weight gain was greater with olanzapine.

Sunday, December 3, 2006

Etiologies of Psychosis in Schizophrenia

Click on the image for a larger view.

Reference: Neuroprotection Schizophrenia

Nova Scotia Disabled Persons Commission discusses United Nations Convention

From the Eastern Views blog:
This August in New York, following five years of negotiating, the UN achieved a Convention on the Rights of Persons with Disabilities (note, this link doesn't always work). Two Nova Scotians, Steven Estey and Dulcie McCallum, represented the Non-Government Organization sector on the Canadian delegation that developed the treaty.

"Canada was particularly helpful regarding the area of legal capacity of individuals with intellectual and psychiatric disabilities" said Estey.

Nova Scotia Disabled Persons Commission (DPC) Executive Director Anne MacRae asked if it would be helpful for the DPC to organize a meeting of the regional provincial disability organizations to plan an information session about the convention. Mr. Estey stated that this would be a very good idea and that he and his organization, the Council of Canadians with Disabilities, would welcome the DPC's input and thoughts to figure out the best strategy.

Saturday, December 2, 2006

Questioning Drug Costs In Schizophrenia Treatment

From the December 1, 2006 issue of Psychiatric News:

The controversy over whether the high costs of second-generation antipsychotics (SGAs) are associated with significant benefits that justify prescribing them rather than cheaper first-generation antipsychotics (FGAs) is the subject of the cost-effectiveness analysis from the National Institute of Mental Health-sponsored CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness) study, reported in the December American Journal of Psychiatry (AJP).

However, the usefulness of the report is challenged by an accompanying editorial, signed by AJP Editor in Chief Robert Freedman, M.D., and cosigned by schizophrenia and antipsychotic medication experts William Carpenter Jr., M.D., and John Davis, M.D.; and Howard Goldman, M.D., Ph.D. (an AJP associate editor), Carol Tamminga, M.D. (an AJP deputy editor), and Marshall Thomas, M.D.
Drugs studied:

Ziprasidone-induced cognitive enhancement in schizophrenia: Specificity or pseudospecificity?

From the December 1, 2006 issue of Psychiatric News:
Ziprasidone [Geodon] may be associated with a significant improvement in cognition in patients with schizophrenia. A 12-week, open-label trial with 10 patients who met nonresponse criteria on their current antipsychotic medication were switched to ziprasidone. Comprehensive cognitive testing was done at baseline and 12 weeks.

Significant improvement was seen on three measures of episodic memory along with a trend toward improvement on tests involving processing speed and executive function.

The data, researchers said, "suggest that ziprasidone has cognitive benefits unrelated to an influence on other disease parameters."

The study was funded by Pfizer Inc.

Reference: Schizophrenia Research 2006: 87;181-184

Sunday, November 26, 2006

Strategies for Maximizing Clinical Effectiveness in the Treatment of Schizophrenia.

In an recent article published by the Journal of Psychiatric Practice, Tandon et al. and the Treatment Effectiveness in Schizophrenia Consortium have presented valuable information on treatment strategies for schizophrenia.

Here is the abstract:
The ultimate clinical objective in the treatment of schizophrenia is to enable affected individuals to lead maximally productive and personally meaningful lives. As with other chronic diseases that lack a definitive cure, the individual's service/recovery plan must include treatment interventions directed towards decreasing manifestations of the illness, rehabilitative services directed towards enhancing adaptive skills, and social support mobilization aimed at optimizing function and quality of life.

In this review, we provide a conceptual framework for considering approaches for maximizing the effectiveness of the array of treatments and other services towards promoting recovery of persons with schizophrenia. We discuss pharmacological, psychological, and social strategies that decrease the burden of the disease of schizophrenia on affected individuals and their families while adding the least possible burden of treatment.

In view of the multitude of treatments necessary to optimize outcomes for individuals with schizophrenia, effective coordination of these services is essential. In addition to providing best possible clinical assessment and pharmacological treatment, the psychiatrist must function as an effective leader of the treatment team. To do so, however, the psychiatrist must be knowledgeable about the range of available services, must have skills in clinical-administrative leadership, and must accept the responsibility of coordinating the planning and delivery of this multidimensional array of treatments and services.

Finally, the effectiveness of providing optimal individualized treatment/rehabilitation is best gauged by measuring progress on multiple effectiveness domains. Approaches for efficient and reliable assessment are discussed.

Wikipedia Information on Schizophrenia

A comprehensive overview of schizophrenia as posted on Wikipedia.

Data from a PET study suggests that the less the frontal lobes are activated (red) during a working memory task, the greater the increase in abnormal dopamine activity in the striatum (green), thought to be related to the neurocognitive deficits in schizophrenia.

Saturday, November 25, 2006

Overview of Schizophrenia

This site provides a simple overview of schizophrenia, including both positive and negative symptoms.