Source:
http://www.dailytrojan.com/article.do?issue=/V150/N14&id=03-prof.14c.html
Stimulating Environment May Curb Schizophrenia
Fri Oct 10
NEW YORK (Reuters Health) - An enriched, stimulating environment during
childhood seems to reduce the likelihood of developing schizophrenia and
criminal behavior in young adulthood, according to a study in Mauritius.
Although several reports have suggested a link between environmental
factors and these mental health problems, few studies have looked at
early childhood interventions as a means of preventing them.
Dr. Adrian Raine, from the University of Southern California at Los
Angeles, and colleagues assessed the effects of an environmental
enrichment program at ages 3 to 5 years on the risk of
schizophrenic-like personality and antisocial behavior at ages 17 and 23
years.
The study involved 438 children from Mauritius who were born in 1969 or
1970. Half participated in the special program while the remainder
experienced the usual community conditions and served as a comparison
control group.
The enrichment program emphasized a stimulating environment and focused
on three key elements -- nutrition, education, and physical exercise.
The program was delivered daily at two specially constructed nursery
schools by a specially trained staff.
Compared with controls, program participants scored lower on tests of
schizophrenia-like disorders and antisocial behavior at age 17 years.
They were also less likely to have a history of criminal behavior.
The strongest benefits were seen among children with evidence of
malnutrition at 3 years of age.
"We caution that findings from a country that was still developing when
the prevention program was conducted cannot be directly extrapolated to
more developed countries such as the US," Raine's team cautions.
"Nevertheless," they write, "the findings may be particularly relevant
to poor rural areas of the US...and also to US inner cities, where rates
of both malnutrition and behavioral problems in children are relatively
high."
SOURCE: American Journal of Psychiatry, September 2003.
This system described below sounds like something that could be valuable
in a lot of doctor's offices, mental health support group offices, and
public assistance offices - I hope it gets properly funded and developed -
Editor.
E-psychiatrist for quick diagnosis of Schizophrenia
Jennifer Foreshew
SEPTEMBER 16, 2003
DOCTORS will be able to screen for, and monitor, mental health disorders,
including schizophrenia and dementia, with a system created at Queensland
University, Australia.
Developed over the past 18 months by the university's Centre for Online
Health, the system, known as Ex-Ray, uses speech and text to diagnose
patients. Work is under way on adding imaging to the system.
Professor Joachim Diederich and Professor Peter Yellowlees say Ex-Ray will
provide a tool as capable as an expert psychiatrist. "We not trying to
pretend this is better than the psychiatrist, but we are suggesting it may
be better than many primary care clinicians."
Professor Yellowlees, professor of psychiatry and director of the Centre
for Online Health, said the PC-based test required a two to five minute
descriptive speech and/or image sample from the patient.
The data was then analysed and classified to provide immediate analysis to
assist diagnosis.
"When people with schizophrenia speak, it is not uncommon for them to be
difficult to understand," Professor Yellowlees said.
"To the layperson their speech can be odd, unusual or a bit confusing."
The same was true with depression, he said. People tended to speak in a
way that was "classically sad".
Ex-Ray combines a number of search engines, essentially, that are used for
neural networks and other machine learning approaches.
It uses algorithms to come up with a cluster of words that are identified
in particular illnesses.
In three trials, Ex-Ray delivered about 80 per cent accuracy as a
screening test for both schizophrenia and depression.
The team is seeking extra funds to extend the trials.
Professor Yellowlees estimated the global market for the tool could be $2
billion annually, including the US.
The system may assist in diagnosis, screening and monitoring of a range of
disorders that affect up to 16 per cent of the population, such as
depression, schizophrenia, mania, dementia, delirium, drug psychoses,
stroke, ataxia and a number of neurological disorders such as Parkinson's
Disease.
Ex-Ray, a project of Uniquest, the university's commercial arm, recently
won an award in the e-health category of the government and corporate
sponsored Secrets of IT Innovation Competition 2003.
Professor Yellowlees said the team had about six months of preliminary
experiments, at a cost of $300,000, to complete, and another two years of
detailed commercial development at $2 million.
"If we got substantial funding tomorrow we could get this going fairly
quickly," he said.
Professor Yellowlees said the tool could allow classification to be
quantified mathematically and more accurately.
RELATED LINKS
www.coh.uq.edu.au
Source: Australian IT News
http://australianit.news.com.au/articles/0,7204,7276476%5E15345%5E%5Enbv%5E15306-15316,00.html
Late-onset schizophrenia can lead to dementia
Last Updated: 2003-09-29 16:31:55 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Many individuals who develop symptoms of
schizophrenia when they are 50 years of age or older exhibit a rapid
decline into dementia, Australian investigators report.
However, the symptoms of older schizophrenic patients who do not develop
this rapid decline in their mental capacities, actually improve over time,
Dr. Henry Brodaty of Prince of Wales Hospital, Sydney, and colleagues
report in the British Journal of Psychiatry.
Schizophrenia is a severe brain disorder that alters a person's emotions,
thought processes and perceptions of reality. Symptoms can include apathy,
hallucinations and delusions.
Most of the time, symptoms of the disorder surface during the late teens
and 20s. And while most patients with schizophrenia have some difficulty
with memory and intellectual functioning, these mental deficits are
usually stable over time.
A
small proportion of patients with schizophrenia don't develop symptoms
until late adulthood, and this type of schizophrenia is not as well
understood as the typical form.
Brodaty and colleagues studied 27 patients with late-onset schizophrenia
and 34 healthy subjects. Average age of both groups was around 70 years.
During the first year of the study, there was no evidence of cognitive
decline in either group.
But after five years, approximately half of the schizophrenic patients,
and none of the control subjects, had been diagnosed with dementia. Five
of the 19 schizophrenic individuals who were still in the study were
diagnosed with Alzheimer's disease, one with dementia due to strokes in
the brain, and three with other kinds of dementia.
Brodaty's team also found good news in their data: Among individuals who
did not develop dementia, their schizophrenia seemed to resolve at least
partially, sometimes altogether, after five years.
The group hopes to find out why some late-onset schizophrenia patients
decline so rapidly by looking at possible genetic causes, conducting more
neuropsychiatric testing, and looking at patients' brain scans.
SOURCE: British Journal of Psychiatry, September 2003.
This story has been adapted from a news release issued by Medical College
Of Georgia.
FDA Seeks Diabetes Warning on Anti-Psychotic Drugs
By Ransdell Pierson
NEW YORK (Reuters) - U.S. regulators have requested that six of the most
widely used anti-psychotic drugs carry a warning that they can increase
the risk of elevated blood sugar and diabetes, Eli Lilly and Co. said on
Wednesday.
Indianapolis-based Lilly, which makes the top-selling schizophrenia
treatment Zyprexa, said the U.S. Food and Drug Administration (news - web
sites) is also seeking the warning on the product labeling for Johnson &
Johnson's rival Risperdal, Novartis AG's Clozaril, Bristol-Myers Squibb
Co.'s Abilify, AstraZeneca Plc's Seroquel and Pfizer Inc.'s Geodon.
Lilly, which received a letter from the FDA on Monday, said more research
is needed into the possible link.
All six of the drugs are so-called atypical anti-psychotics, a newer
generation of medicines that do not cause some of the troublesome side
effects, such as tremors, seen in older treatments.
FDA spokeswoman Susan Cruzan confirmed the agency had asked makers of
atypical anti-psychotics to add the new warning. She said epidemiological
studies suggested a link between treatment with the drugs and an increased
risk of diabetes.
Analysts have speculated the FDA might require the diabetes warning for
some or all of the atypical drugs, following results last month of a
long-awaited study that linked three of the medicines to higher incidence
of the disease.
The study, involving almost 20,000 schizophrenia patients treated at
veterans' hospitals and clinics across the United States, showed patients
taking Seroquel had 3.34 times as many cases of diabetes as those on older
drugs.
With Risperdal, the rate was 1.49 times, or 49 percent, greater than that
of the older drugs. Patients on Zyprexa were 1.27 times more likely to
become diabetic.
The veterans study erased much of the stigma from Zyprexa, whose U.S.
sales have slowed in the past year because it tends to cause more weight
gain among patients than other atypicals.
Because obesity is a leading cause of Type II diabetes, many doctors and
industry analysts had wrongly assumed Zyprexa posed the greatest diabetes
risk to patients.
"The new label warning will have very limited impact on sales of any of
the atypical drugs because doctors are already very familiar with their
link to diabetes," said Sena Lund, an analyst with Cathay Financial LLC.
"Doctors will focus on the effectiveness of these drugs instead of
diabetes risk," said Lund, who predicted few doctors would switch to older
drugs because they are less effective than the atypicals.
Concerns about Zyprexa have played mostly into the hands of Bristol-Myers,
whose recently launched Abilify does not cause significant weight gain
among schizophrenics -- a population that is already at high risk
of developing Type II diabetes.
New Movie Review: Man's descent into schizophrenia avoids cinematic
stereotype
09/25/03
John Petkovic
Plain Dealer Reporter
Films about schizophrenia always seem to take on one of two personalities.
There's the sentimental drama about mental illness - the one where
never-ending compassion leads to a happy ending. Then there's the other
extreme: A "mad man" goes on a rampage loaded with "deranged" dialogue and
twisted faces.
Then there's "Revolution #9."
Tim McCann's portrait of a young man's descent is a film in search of a
personality. Will it end happily? Violently? Hopeful or hopeless? You
never really know, but that's what makes it such an engaging journey.
The film follows James (Michael Risley), a 27-year-old Manhattan apartment
dweller. He's smart, handsome and successful - on the surface. Inside,
Jackson is a tumultuous soul who believes that he's being controlled and
manipulated by the media.
That might sound heavy-handed. At times, it is. But McCann is deft at
mixing obsessive camera work like that of Roman Polanski with the detached
cyber-angst of David Cronenberg to make it work.
James' trigger is a TV ad for a perfume called "Rev 9." Most would write
it off as a just another pretentious perfume commercial that mixes sex
with camera gimmicks and abstract gibberish to sell a potion.
Not Jackson. He sees it as a much more insidious form of mind control. So
much so that he poses as a journalist and tracks down the director of the
spot. It leads to a confrontation, er, I mean, an "interview," as well as
the film's most warped scene.
Spalding Gray is impeccable as the pompous director who compares his
"personal vision" to the cinema of Italian art-house director Michelangelo
Antonioni. James wants none of it. He wants to know, "What do MTV and the
Roman Empire have in common?"
It would be funny if the rest of "Revolution #9" wasn't so realistic.
Over the course of nine numbered scenes, James' inner turmoil not only
bubbles out but consumes his fiancee, Kim (Adrienne Shelly). She tries to
get him help at every twist and turn, only to run into one hurdle after
another - their families, a bureaucratic mental-heath system and a cold,
cold world that refuses to understand.
How do you relate to someone suffering from such a disease? Where do you
go to get them help? How do you get through to the other side?
"Revolution #9" doesn't provide answers. But it explores the problem with
the kind of nuance we rarely see on the screen.
For more information on the movie:
http://movies.yahoo.com/shop?d=hv&id=1808442823&cf=info&intl=us
http://www.trashcity.org/BLITZ/BLIT0850.HTM
PRESS RELEASE
FDA Approves ABILIFY(TM) (Aripiprazole) for Maintaining Stability in
Patients With Schizophrenia (September 8, 2003)
PRINCETON, N.J. and TOKYO, Sept. 8 /PRNewswire-FirstCall/ -- Bristol-Myers
Squibb Company (NYSE: BMY - News) and Otsuka Pharmaceutical Co., Ltd.
announced today that the U.S. Food and Drug Administration (U.S. FDA)
approved a Supplemental New Drug Application (sNDA) for ABILIFY(TM) (aripiprazole)
for maintaining stability in patients with schizophrenia.
"Because schizophrenia is a chronic illness that requires ongoing
treatment, it is important for physicians, consumers and family members to
have information regarding the longer-term use of medication," said Dr.
Peter Weiden, Director of the Schizophrenia Research Program and Professor
of Psychiatry, SUNY Downstate Medical Center. "These data demonstrate that
ABILIFY is efficacious in the treatment of schizophrenia for up to 26
weeks. In addition, the study demonstrated there were no medically
important differences between ABILIFY and placebo in several metabolic
measures."
The sNDA included results from a placebo-controlled trial involving 310
inpatients or outpatients meeting DSM-IV criteria for schizophrenia who
were, by history, symptomatically stable on other antipsychotic
medications for periods of 3 months or longer. These patients were
discontinued from their antipsychotic medications and randomized to
ABILIFY 15 mg/daily or placebo for up to 26 weeks of observation for
relapse. In this study, patients who received ABILIFY 15mg/daily
experienced a significantly longer time to relapse over the subsequent 26
weeks compared to those receiving placebo; the relative risk of relapse
for aripiprazole-treated patients was half that of placebo-treated
patients (relative risk of relapse for aripiprazole:placebo = 0.503, p <
0.001). Physicians who elect to use ABILIFY for extended periods should
periodically re-evaluate the long-term usefulness of the drug for
individual patients.
In this long-term trial, there were no medically important differences in
metabolic profile between patients receiving ABILIFY and placebo in mean
change from baseline in prolactin, fasting glucose, triglyceride,
high-density lipoprotein (HDL, or "good" cholesterol), low-density
lipoprotein (LDL, or "bad" cholesterol) and total cholesterol
measurements.
Overall mean weight change in patients receiving ABILIFY over the course
of the study was -1.3 kg (-2.86 lbs) compared to -0.9 kg (-1.98 lbs) in
placebo-treated patients.
Overall weight change among ABILIFY-treated patients in a previously
conducted 52-week trial was +1.0 kg (+2.20 lbs). When patients in this
study were grouped by BMI, weight change in patients and the percentage of
patients with >/=7% increase in body weight were as follows: +2.6 kg
(+5.72 lbs) and 30% in patients with BMI <23; +1.4 kg (+3.08 lbs) and 19%
in patients with BMI 23-27; and -1.2 kg (-2.64 lbs) and 8% in patients
with BMS >27.
In previously conducted short-term (4- and 6-week) placebo-controlled
trials with ABILIFY, there was no difference in the incidence of
discontinuation due to adverse events between patients treated with
ABILIFY (7%) and placebo (9%) or incidence of extrapyramidal syndrome (6%
vs. 6%). In addition, studies showed that ABILIFY was associated with a
moderate difference in sedation (11% vs. 8% for placebo), and did not
cause significant QTc interval changes. The adverse events reported in the
26-week trial were generally consistent with those reported in the
short-term trials, except for a higher incidence of tremor (9% ABILIFY vs.
1% placebo). In this study, the majority of these cases were of mild
intensity, occurred early in therapy (...49 days) and were of limited
duration (...10 days). Tremor infrequently led to discontinuation (<1%) of
ABILIFY. In addition, in a long-term (52-week) active controlled study,
the incidence of tremor for ABILIFY was 4.0%.
The most commonly reported adverse events associated with ABILIFY in
short-term clinical trials are headache (32% vs. 25% placebo), anxiety
(25% vs. 24% placebo), insomnia (24% vs. 19%), nausea (14% vs. 10%
placebo), vomiting (12% vs. 7% placebo), sleepiness (11% vs. 8% placebo),
lightheadedness (11% vs. 7% placebo), restlessness (10% vs. 7% placebo)
and constipation (10% vs. 8% placebo).
ABILIFY, the most recently approved treatment for schizophrenia in the
United States, Mexico, Brazil, Puerto Rico, Peru, El Salvador and
Australia, has been prescribed for more than 200,000 people in the United
States.
ABILIFY is available in 5 mg, 10 mg, 15 mg, 20 mg and 30 mg tablets.
ABILIFY is available by prescription only.
For more information, please see
http://www.abilify.com
SOURCE: Bristol-Myers Squibb; Otsuka Pharmaceutical Co., Ltd.
PRESS RELEASE
SOLVAY PHARMACEUTICALS AND LUNDBECK MOVE INTO CLINICAL PHASE III WITH
JOINT SCHIZOPHRENIA TREATMENT, BIFEPRUNOX
(PRESSI.COM 09/02/2003) Solvay Pharmaceuticals and H. Lundbeck A/S today
announce their joint decision to move bifeprunox into clinical phase III
with immediate effect. The decision to move into phase III follows the
successful completion of the joint phase II program. In December 2000 the
two companies announced that they would join forces in the development and
marketing of this atypical antipsychotic, bifeprunox.
Bifeprunox is a product of Solvay Pharmaceuticals' drug discovery efforts.
It was formerly known under its lab code DU127090. It is a putative full
spectrum atypical antipsychotic compound aimed at the treatment of both
positive and negative symptoms of schizophrenia. Its mechanism of action
couples a highly potent partial agonism of the dopamine D2 receptors to an
additional 5HT1A receptor partial agonist effect.
A
recently finalised placebo controlled dose-finding study showed bifeprunox
to be efficacious and well tolerated in the treatment of patients with
schizophrenia. As desired, the tolerability profile was very encouraging
with no indication of weight gain, cardiovascular or extra pyramidal side
effects (EPS).
Schizophrenia is a severe disabling and chronic form of psychosis that
develops in approximately 1% of the population. Schizophrenia is
characterised by positive, negative, affective and cognitive symptoms.
Positive symptoms comprise, among others, delusions and hallucinations.
The negative symptoms include social withdrawal, blunted affects and
diminished capacity of speech. Affective symptoms are mainly depression
and anxiety. Typical cognitive deficits are impaired attention and memory
and some times disorganised speech. While currently most widely used
treatments may be effective in controlling acute symptoms of schizophrenia
they are all associated with a variety of side effects that negatively
influence their usefulness in long-term treatment. New treatments that
improve symptomatology but with reduced side effects are therefore
desirable.
Solvay Pharmaceuticals global head of Research and Development, Werner
Cautreels, said "new and better medicines for treating schizophrenia are
really needed by psychiatrists and bifeprunox is looking very promising.
We hope to be able to bring it to markets in just a few years time"
Lundbeck's Executive Vice President, Research & Development, Claus
Bręstrup says "we are pleased with the smooth way this joint project is
progressing between the partners, and naturally delighted that the
clinical results of phase II studies encourage an immediate start of a
joint phase III program".
Under the terms of the agreement between the two companies Solvay retains
the marketing rights in the US, Canada, Mexico and Japan, while Lundbeck
gains the marketing rights for Europe and the rest of the World. Lundbeck
and Solvay will jointly market the product in Brazil and Argentina.
For further information please contact :
SOLVAY S.A. Headquarters
Martial Tardy
Corporate Press Officer
E-mail : martial.tardy@solvay.com
Internet :
www.solvay.com
