New Drink
may Help Medication Benefits, Reduce Side Effects
UK Researchers
have developed a drink that may improve the
effectiveness of anti-psychotic medications for illness
such as mania and schizophrenia.
Funded by
the biomedical research charity The Wellcome Trust, the
team from the Department of Psychiatry at Oxford
University found that supplementing medication with a
drink (Tyrodep) rich in amino acids helps to moderate
the increased chemical levels in the brain that underlie
some psychotic symptoms.
The
addition of the drink to medication may improve the
medication's beneficial effects while reducing unwanted
side-effects, leading to improved treatment compliance
in the future. According to Professor Guy Goodwin,
leader of the Oxford research team, “The drink we’ve
developed, when taken alongside medication, has proven
to be a real step forward. It may be both more
acceptable to patients and help to reduce the unwanted
side effects people get from their treatment. Hopefully
it will allow them to get on with their lives.”
The Stanley Medical Research Institute in the United
States is now working with Professor Goodwin to further
develop the drink into a more widely available therapy.
For the
full article, please see the
full-text news article, or see the
BBC.com article on the same subject.
For
research on the effects of amino acid depletion (notable
tryptophan) on schizophrenia symptoms, please see the
following PubMed abstract:
Acute Tryptophan Depletion in Schizophrenia.
Nutrition Affects Long-Term Schizophrenia Outcome
Results
from four out of five placebo-controlled studies in
England, as well as a cross-national analysis of
schizophrenia outcomes in relation to national dietary
practice, all confirm that an excess of sugar and
saturated fat in the diet appears to worsen the
long-term outcome of schizophrenia.
Consuming
high amounts of sugar and fat cause the brain to produce
less of the protein product brain-derived neurotrophic
factor (BDNF). BDNF plays an important role in forming
new neural growths and synapses.
Malcom peet
of Swallownest Court Hospital confirms the effects of
diet. "It appears that the same dietary factors which
are associated with the metabolic syndrome, including
high saturated fat, high glycemic load, and low omega-3
PUFA, may also be detrimental to the symptoms of
schizophrenia, possibly through a common mechanism
involving brain-derived neurotrophic factor."
Source:
Managed Care Law Weekly, pg. 70
For
additional information, see the published research
online -
Schizophrenia and nutrition: beyond omega-3 fatty acids
Leading to Lead: Conflicting Rules May Put Lead in Tap
Water
Source:
Scientific American, June 21 2004
The
following is an excerpt from a recent Scientific
American article, reporting on how different regulations
for water purification can inadvertantly cause an
increase in lead found in tap water. This is
particularly relevant to us at schizophrenia.com, as
several studies have shown that fetal exposure to lead
during pregnancy can double or triple the child's risk
of developing schizophrenia or other mental disorders.
For research on the link between lead exposure and
schizophrenia, please visit
Schizophrenia.com - Causes and Prevention
Report
by Rebecca Renner
The
public reporting last year of high lead levels in the
drinking water in Washington, D.C., has led to a
congressional investigation, the firing of a D.C. health
official, and calls for a review of the 1991 law that is
supposed to keep the neurotoxic metal out of drinking
water. That law, however, may not contribute to the
problem as much as the changes made to disinfection
procedures resulting from another water safety rule. The
conflicting regulations mean that other municipalities
may also soon find too much lead coming out of their
faucets.
Lead
should not normally enter the flow, because layers of
different lead-snaring minerals naturally build up
inside the pipes. But these mineral scales act as a trap
for lead only as long as they remain insoluble; a sudden
shift in water chemistry can change that.
Such a
change may have triggered the D.C. problems. In 2000
Washington Aqueduct, the area's water treatment plant,
modified its procedures to comply with the 1998
Disinfection Byproducts Rule (DBR), which restricts the
presence of so-called halogenated organic compounds in
water.
One of
the most common ways to comply with the DBR is to use a
mixture of chlorine and ammonia--called
chloramines--instead of chlorine. Some 30 percent of
major U.S. water companies currently take this route,
and the proportion will probably grow as limits on
disinfection by-products are tightened during the next
few years.
Evidence
for chloramines' effect on Washington's pipes comes from
EPA chemist Michael Schock. He discovered that different
mineral scales--especially lead dioxide scales--are
particularly vulnerable to changes in water chemistry.
With chlorine, Washington's water was highly oxidizing.
As a result, the mineral scales that formed consisted of
lead dioxide, which Schock has found in every sample of
Washington's lead service lines that he has examined.
The switch to chloramines lowered the oxidizing
potential of D.C.'s water, which probably dissolved the
lead dioxide scale and thereby liberated the lead.
"We were
concerned that drastic changes in water treatment could
disturb scales and mobilize metals," says one scientist
involved in the investigation of the D.C. lead problem,
who asked not to be named.
For more
information, please see the full article at
Scientific American, "Leading to Lead" (June 21,
2004)
A
Smokeless Alternative to Quitting - "Snus" smokeless
tobacco a safer meantime option
This
popular Swedish product might be welcome news to the
80-90% of schizophrenia patients who smoke. "Snus",
comparable to snuff, is used by half of all male Swedish
tobacco users (40% of the entire Swedish population),
which may explain why Sweden also has one of the lowest
incidences of lung cancer. The country has also been
notably successful (as compared to other European
countries) in reducing smoking in the general
population.
The miracle
product itself is a small tea-bag like packet of oral
tobacco, which is held between the lip and the gum. It
produces neither smoke nor spit, the largest complaints
of non-smokers about their smoking compatriots. Better
yet, epidemiological studies have shown that smokeless
tobacco significantly reduces a previous smoker's risk
of developing oral cancer.
Although
the safest and most healthy (not to mention the most
economical) option is swearing off all nicotine and
tobacco products, alternatives such as snus may be a
healthier hold-out for smokers who can't quit cold
turkey. For schizophrenia patients, who may (among other
reasons) use smoking for its calming effects in the
midst of an extremely stressful disease and lifestyle,
such options could be an easier path away from a
dangerous habit. However, it could be particularly
important for those with schizophrenia to eventually
kick the habit; research shows that nicotine can reduce
the blood levels of certain antipsychotic medications,
making the overall treatment less effective.
For the
full article (and the commentary of Sally Satel, MD),
please see
A Smokeless Alternative to Quitting (NY Times, April
6, 2004).
For more
information on smoking among schizophrenia patients,
please see
"Schizophrenia and Substance Abuse" at
http://psychcentral.org
Majority
of Schizophrenia Patients Not Totally Compliant with
Treatment Regimen
According to an April 2004 study in the American Journal
of Psychiatry, only 41% of diagnosed patients regularly
take their prescribed medications.
Out of the
rest, 24% are completely non-compliant, and 17% are
partially compliant with their treatment regimen.
Another 19% are "excess fillers" - people who fill their
prescriptions more frequently than they are prescribed.
Those who lived independently or were homeless were more
likely to be non-adherent.
It is a
well-documented fact that treatment non-compliance,
aside from the obvious detriments to the mentally ill
patient, significantly raises out-patient and hospital
medical costs.
This
research shows the need for better managment,
communication, and follow-up from healthcare providers,
pharmacists, family members, and case-management
workers.
For more
information, please see the
full-text article
For further
perspectives and suggestions concerning treatment
compliance, please see
Assisted Outpatient Treatment article or
Medication: The Foundation of Recovery
Success
Story - Schizophrenia Patient Working as NAMI Advocate
Marc
Stolzer was a bright and active college junior, an
honors student and talented athlete at Penn State
University, when he began to notice certain changes in
his moods and behavior. These uncharacteristic patterns
deteriorated rapidly into 'mental breaks from reality',
or psychotic episodes involving visual and auditory
hallucinations.
Stolzer's
health forced him to withdraw from college, and he
returned home to live with his parents, where he became
even more withdrawn, isolated, and irrational. Finally,
Stolzer's parents checked him into a hospital following
a suicide attempt, where he was diagnosed with
schizophrenia at the age of 21.
Doctors
speculated that a past head injury from a bicycle
accident may have been the trigger to his symptoms.
Even after
beginning medication and a rehabilitation program,
Stolzer said his psychotic symptoms and episodes
continued to wax and wane. However, contrary to a
commonly held stigma against the mentally ill, Stolzer
says he never felt any violent impulses due to his
condition.
"The stigma
with schizophrenia is that people who have it are
violent...most people with mental illness would rather
hurt themselves than another person," Stolzer said.
With the
help of medication, a support network of family and
friends, and a long-term recovery phase, Stolzer has
successfully controlled his psychotic symptoms.
"Thank God
for the medication, because without it, I would not be
productive," Stolzer said.
Now 46,
Stolzer currently works with the National Institute for
the Mentally Ill (NAMI) to dissolve such stigmas. He
gives lectures to companies, medical professionals,
schools, and other institutions to help spread
understanding about how a mental illness affects a
person, their life, and their actions. As well as
educating the public, Stolzer also hopes to assist other
mentally ill patients to integrate themselves back into
life and society.
Source: NJ
Sentinel, June 10, 2004
For the
full article, please see the
full-text news article. Please also see the
personal success stories of schizophrenia.com members.
Math
Ability and Schizophrenia - In Families With Psychosis,
The Numbers Tell a Story
Is there
any link between math talent and mental illness? A
researcher in Iceland finds that the incidence of
psychosis is greater than expected among mathematical
scholars.
The movie
"A Beautiful Mind" about John Nash, a math genius who
had schizophrenia. Nash illustrates what an Icelandic
psychiatrist has now found—that there may be a link
between psychosis and math talent.
The study,
conducted by Jon Karlsson, M.D., Ph.D., director of the
Institute of Genetics in Reykjavik, Iceland, has found
an intriguing relationship between math talent and
psychosis susceptibility in the Icelandic population.
Results were published in the April British Journal
of Psychiatry.
These
findings add an interesting perspective to the
popularly-known but not well studied hypothesis that
people predisposed to mental illness may benefit from
extra touches of creative genius. "Psychotic disorders,"
suggests Karlsson, "might be associated with some
favorable effect, as this would explain their
surprisingly high frequency in all human populations.
Geneticists refer to such systems as balanced
polymorphisms, mutant genes tending to exist at
unexpectedly high levels if their heterozygous carriers
benefit in some manner from the phenomenon...."
For more
information, please seee the
full-text news article. For further reading about
the proposed genetic link between creativity and mental
illness, please see
Creativity and Schizophrenia.
Link
between IQ and Psychosis Risk
A recent study
of 50,000+ men indicated that higher IQ scores may
decrease the risk for developing psychotic symptoms or
disorders. Men with lower-than-average IQ scores had a
40% greater risk of developing schizo-affective
disorder, as compared with those subjects with the
highest IQ scores. This findings corroborate those of
earlier studies, which linked early-onset schizophrenia
and lower-than-average childhood education scores
IQ may
bestow protection against psychosis by either
influencing interpretation of stimuli and events, or may
be an outward marker of subtle cerebral disease that
could eventually influence development of psychotic
symptoms.
There was
no similar link reported between IQ and bipolar
disorder.
Please note
that what this research is saying is that the lower the
IQ that a person has, the higher the RISK of
schizophrenia. This does not mean that all people with
schizophrenia have low IQ - as people like Nobel
Laureate John Nash have proven very clearly. All this
research means is that the risk of developing
schizophrenia seems to be higher for those people with
lower IQ.
Click here
for the
PubMed research abstract for the above study.
A
longitudinal study of premorbid IQ Score and risk of
developing schizophrenia, bipolar disorder, severe
depression, and other nonaffective psychoses
This
relationship between lower IQ and higher risk of
schizophrenia has been found in a number of studies;
furthermore, the lower the IQ, the poorer the outcome
tended to be. Here are some of those recent studies on
this subject:
Factor analysis on the intelligence of patients with
schizophrenia
Premorbid IQ and schizophrenia. Increasing cognitive
reduction by episodes
Brain volume, asymmetry and intellectual impairment in
relation to sex in early-onset schizophrenia.
Decreased level of psychobiological factor novelty
seeking and lower intelligence in men latently infected
with the protozoan parasite Toxoplasma gondii Dopamine,
a missing link between schizophrenia and toxoplasmosis?
IQ in childhood psychiatric attendees predicts outcome
of later schizophrenia at 21 year follow-up
To find
more of these studies - go to
www.pubmed.org and type in "schizophrenia and IQ".
Of possible relevance to this issue is recent research
that suggests that the vitamin supplement called Choline
- when taken by pregnant mothers - can substantially
improve the brain function and memory capacity (ie. IQ
or intelligence) of children and this effect continues
through to adulthood (at least in Rats and Mice so far
tested - it will obviously take 20 to 40 years for this
to be proven in people). Given that Rats have proven to
be very good models for how drugs work in human brains,
there is good reason for believing that this research
that was done in rats will also hold true for humans.
For more information on this see the following:
Choline Supplementation During Pregnancy Improves Brain
Function throughout lifespan of child, and May Reduce
Risk of Schizophrenia
Glutamate
Levels Elevated in Teens At-Risk for Schizophrenia
A recent study
published in the American Journal of Psychiatry
highlights glutamate as a possible key factor in
schizophrenia.
Published
results showed that teens judged to be at a high genetic
risk for developing schizophrenia had abnormally
elevated levels of glutamate in their brains, as
compared with teens who had no risk.
The finding
supports a previously suggested hypothesis that
"glutamate system dysfunction may play a role in
neuroarchitectural abnormalities seen in
schizophrenia...," says Philip Tibbo, M.D., an assistant
professor of psychiatry at the University of Alberta in
Edmonton, Canada and the primary investigator in the
study.
Although
the research provides intriguing insight into the
possible brain pathology of the disease, the findings
have no practical clinical application at the moment. In
other words, psychiatrists don't usually have H-MRS
scanners laying around the office so they can easily
test brain glutamate levels.
For more
information, see the
full-text news article or the
published study. For further reading about the
possible role of glutamate in schizophrenia, and how it
may effect symptoms and future treatments, see Society
of Neuroscience
May 2004 Brain Briefings: Cognition and Schizophrenia.
Schizophrenia and Psychotic Depression are
Neurologically Similar
Psychotic
depression may be a little-known first cousin of
schizophrenia, University of Illinois study suggests.
Investigators performed extensive neuropsychological
analysis testing on 106 patients admitted for a
psychotic disorder and later diagnosed with either a
schizophrenia spectrum disorder, schizoaffective
disorder, or unipolar depression with psychotic
features. Investigators did not know the official
diagnosis at the time of the neurological testing. They
then compared those patient profiles with 14
nonpsychotic unipolar depression patients and 81 healthy
individuals who underwent the same tests.
"To our
knowledge," the researchers asserted in their study
report, "this is the first study to provide data that
document the neuropsychological profile of psychotic
depression in young adults at the time of the first
episode of illness, before treatment with antipsychotic
medication."
Analysis of
the subjects' profiles showed that individuals with
psychotic depression had a pattern of neuropsychological
dysfunction that appeared to be a milder version of
schizophrenia-disorder patient profiles. Those with
nonpsychotic depression had profiles that more closely
resembled healthy control subjects.
Researchers
conclude on the basis of these results that psychotic
depression involves marked neuropshychological
impairment, and propose that schizophrenia nad psychotic
depression may be pathologically and phsyiologically
similar.
For further
information, see the
full-text news article or the
published study results. For an expert's opinion on
the differences between schizophrenia disorders and
psychotic depression, see
Mental Health Source Ask the Expert.
New
Research Identifies Candidate Genes for Schizophrenia
A team of
researchers at the Mental Health Research Institute
(MHRI) in Melbourne, Australia have identified and
isolated 69 genes that seem to be significantly
implicated in the development of schizophrenia. This
group of genes was selected from a larger group (153
genes) discovered to be expressed at higher or lower
levels in subjects with schizophrenia as compared to
controls. The genes in question, and the hundreds of
proteins that they produce, are now being analyzed to
determine how they affect the etiology of the disease.
The
groundbreaking study used brain tissue samples collected
post-mortem from subjects affected by either
schizophrenia or bipolar disorder, a research technique
made possible by cooperation from the State of Victoria,
Australia. "This approach to understanding the causes of
psychiatric illness has resulted from the generous act
of tissue donation and therefore this research effort
represents a unique partnership between scientists and
the community in Victoria," said Associate Professor
Brian Dean of MHRI.
The
findings were presented at BIO2004, the world's biggest
biotechnology conference, in San Francisco (June 6-9,
2004).
Note: this
is a follow-up article tracking the progress of this
Australian research team. A report detailing the
discovery of the original group of 153 candidate genes
can be found in an earlier
Schizophrenia Update (January 2003).
Source:
State Government of Victoria, Australia
For more
information, please refer to the
full-text article.
Abilify in
Europe - Abilify (Aripiprazole) Approved For Marketing
In Europe For The Treatment Of Schizophrenia
Drug to
Receive Marketing Approval in 25 European Countries
PRINCETON,
NEW JERSEY AND TOKYO, June 7, 2004 -- Bristol-Myers
Squibb Company and Otsuka Pharmaceutical Co., Ltd. today
announced that the European Commission has granted
marketing authorization for Abilify (aripiprazole), an
antipsychotic medication, for the treatment of
schizophrenia. Abilify was approved by the FDA for
marketing in the United States in 2002.
"Receiving
marketing approval for Abilify in 25 nations of the
European Union marks a significant milestone for Abilify
and for both companies, bringing an important medicine
one step closer to the millions of people in Europe
living with schizophrenia," said Peter R. Dolan,
chairman and chief executive officer, Bristol-Myers
Squibb.
"For
patients with schizophrenia, Abilify has a unique
pharmacology among the atypical antipsychotics and has
demonstrated proven efficacy with a comprehensive
tolerability and safety profile," said Tatsuo Higuchi,
president & representative director, Otsuka
Pharmaceutical Co., Ltd. "We are proud to have
discovered Abilify and now be able to offer this
important therapy in the European Union for people in
need of treatment options of schizophrenia. It will also
give Otsuka an opportunity to strengthen the foundations
to introduce more of Otsuka's innovative medicines to
people in Europe."
Otsuka
Pharmaceutical Europe Ltd., the London subsidiary of
Otsuka Pharmaceutical Co., Ltd., holds the marketing
authorization for Abilify in Europe. Bristol-Myers
Squibb and Otsuka will co-promote Abilify in several
European countries.
For more
information, please see the
full-text news article, or visit schizophrenia.com
for
more info on Abilify.
Solvay
Announces New Drug Plans for Schizophrenia
Solvay has
re-evaluated the commercial potential of bifeprunox, a
Solvay compound in clinical development for the
treatment of schizophrenia . Bifeprunox additionally has
the potential to be developed in other disorders, i.e.
bipolar disorder. Following its alliance with Wyeth,
Solvay confirms that peak year sales on the markets
where the partners co-develop and co-commercialize
bifeprunox – the United States and Canada – are in
excess of USD 1 billion.
A recent
article in the Wall Street Journal (June 3, 04) noted
that "The global market for schizophrenia drugs is
valued at around $10 billion a year, and doctors aren't
satisfied with their current roster of treatments.
"We usually
use a mix of drugs," said Dr. Francoise Lotstra, a
psychiatrist who treats schizophrenia at Erasmus
Hospital in southern Brussels. "They're only effective
in 30% to 50% of cases, and there are often side effects
like severe weight gain."
Solvay says
that Bifeprunox users will have no weight gain and no
significant imbalances in their blood-sugar or
cholesterol levels."
These
features of bifeprunox are being further studied in an
extensive phase III clinical program. Solvay and Wyeth
plan to submit file for registration for bifeprunox in
2006 with an expected market launch in 2007.
In Europe
and other markets, bifeprunox is co-developed by Solvay
and H. Lundbeck A/S, an international pharmaceutical
company based in Copenhagen, Denmark. Bifeprunox will be
marketed in those markets by Lundbeck.
Submission
in these markets is also planned simultaneously in 2006
with expected market launch in 2007.
For more
information about bifeprunox clinical trials, please see
the
Solvay press release.
Atypical Antipsychotic Patents to Expire in 2007
Virtually all schizophrenia patients need some sort of
medication therapy to help control their symptoms.
Typical anti-psychotic medications are effective for
some, but many others find the numerous side-effects
unbearable. Moreover, this older school of drugs often
only treats the positive symptoms of schizophrenia
without addressing the cognitive, negative symptoms
which can be equally debilitating.
Many
patients who cannot benefit from typical medications are
finding relief from atypical antipsychotics such as
Zyprexa, Abilify, Risperdal, Seroquel, and Geodon.
Although they can be more effective with fewer side
effects, these drugs are inevitably more expensive.
However,
although they are driving the treatment market now, the
patent on these pharmaceuticals is due to expire in
2007. The door will then be wide open for similar, more
affordable generic drugs.
"Generics
will have the greatest impact on the U.S. market, which
is the largest and most receptive market for generics,"
said Michelle Grady, analyst at Decision Resources.
"This market will experience a 3.0% annual decline over
the period 2008-2013. The launch of depot formulations
of atypical antipsychotics and a few other less
promising emerging agents will be the only protection
against a more precipitous decline."
For more information, please see the
full-text article
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