To examine the efficacy and safety for metformin in treating antipsychotic-induced dyslipidemia.
 Methods: Two randomized placebo-controlled trials were included in the analysis. A total of 201 schizophrenia patients with dyslipidemia after treatment with an antipsychotic were collected, and the patients were divided into two groups: a 1 000 mg/d metformin group (n=103) and a placebo group (n=98). The clinical symptoms and metabolic indicators such as body weight, blood glucose, and blood lipids were assessed at baseline, the 12th week and the 24th week after treatment respectively.
 Results: After metformin treatment, the mean difference in the low-density lipoprotein cholesterol (LDL-C) value between the metformin group and the placebo group was from 0.16 mmol/L at baseline to -0.86 mmol/L at the end of the 24th week, which was decreased by 1.02 mmol/L 
(P<0.01). At the 24th week, the LDL-C was more than 3.37 mmol/L in 25.3% patients in the metformin group, which was significantly lower than that in the placebo group (64.8%) (P<0.01). Compared with the placebo group, there were significant changes in the weight, body mass index (BMI), insulin, insulin resistance index, total cholesterol and triglyceride, and high-density lipoprotein cholesterol (HDL-C) in the metformin group (all P<0.05). The treatment effects on weight and insulin resistance appeared at the 12th week and further improved at the 24th week, but the effects on improving dyslipidemia only significantly occurred at the end of the 24th week.
 Conclusion: The metformin treatment is effective in improving antipsychotic-induced dyslipidemia and insulin resistance, and the effect to reduce the antipsychotic-induced insulin resistance appears earlier than the effect to improve dyslipidemia.
Antipsychotic Agents ; adverse effects ; Blood Glucose ; Diabetes Mellitus, Type 2 ; Double-Blind Method ; Dyslipidemias ; chemically induced ; drug therapy ; Humans ; Hypoglycemic Agents ; Metformin ; therapeutic use

Antipsychotic Agents ; adverse effects ; Child ; Humans ; Hypoglycemic Agents ; therapeutic use ; Metabolic Syndrome ; drug therapy ; etiology ; Metformin ; therapeutic use ; Weight Gain

OBJECTIVETo evaluate the clinical efficacy and safety of aripiprazole in the treatment of childhood tic disorders (TD) by a meta analysis.

METHODSA systematic search for randomized controlled trials (RCTs) on the efficacy and safety of aripiprazole in the treatment of childhood TD that were published between January 2000 and August 2014 was conducted. A Meta analysis on the selected RCTs was conducted using Review Manager 5.2 software.

RESULTSSix RCTs involving 551 TD patients were enrolled. There were no significant differences in the efficacy between aripiprazole and traditional drugs for treatment of TD either by the end of follow-up visit or at 2 weeks, 4 weeks and 8 weeks after treatment. The subgroup analysis results indicated that aripiprazole had the same efficacy for the treatment of TD as traditional drug haloperidol. Aripiprazole had a lower incidence of extrapyramidal reactions than haloperidol (P<0.05), but the overall incidence of side effects of aripiprazole was not lower than traditional drugs for treatment of TD.

CONCLUSIONSThe available evidence suggests that aripiprazole has the same curative effect in the treatment of childhood TD compared with the traditional drugs. However, it is difficult to draw a firm conclusion that aripiprazole is a safer drug in the treatment of childhood TD.

Antipsychotic Agents ; therapeutic use ; Aripiprazole ; adverse effects ; therapeutic use ; Humans ; Tic Disorders ; drug therapy

OBJECTIVETo observe the therapeutic efficacy of Dangfei Liganning Tablet (DLT) in the treatment of antipsychotics induced mild hepatic damage.

METHODSTotally 80 mental inpatients with antipsychotics induced mild liver injury were randomly assigned to two groups, the treatment group (40 cases) and the control group (40 cases). Patients in the treatment group took DLT, two tablets each time, three times per day, while those in the control group took Liver-protecting Tablet (LT), four tablets each time, three times per day. The treatment course was 4 weeks for all. Changes of glutamic-pyruvic transaminase (ALT) and glutamic-oxalacetic transaminase (AST) were observed before treatment, week 1, 2, and 4 after treatment. The therapeutic efficacy was compared between the two groups.

RESULTSCompared with the former time point, ALT and AST gradually decreased in the two groups at week 1, 2, and 4 (P <0. 05). The cured rate was 72. 5% and the total effective rate was 97. 5% in the treatment group. They were 62. 5% and 90. 0% respectively in the control group. There was no statistical difference in the two indices between the two group (P >0.05). No obvious adverse reaction occurred in the two groups.

CONCLUSIONDLT could treat antipsychotics induced mild hepatic damage in a safe and effective way.

Alanine Transaminase ; metabolism ; Antipsychotic Agents ; adverse effects ; Chemical and Drug Induced Liver Injury ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Humans ; Liver ; metabolism ; Protective Agents ; administration & dosage ; therapeutic use ; Tablets ; therapeutic use

OBJECTIVETo assess the efficacy and safety of Wuji Powder (WP) and a small dose aripiprazole in treatment of antipsychotic drug-induced phlegm dampness type amenorrhea.

METHODSSeventy female schizophrenic patients with antipsychotic drug-induced galactorrhea-amenorrhea syndrome (GAS) were recruited and randomly assigned to the treatment group and the control group, 35 in each group. All patients received antipsychotic drug therapy. Patients in the treatment group additionally took WP, while those in the control group took aripiprazole (at the daily dose of 5 mg, once daily). The therapeutic course for all was 4 weeks. Prolactin levels and obesity indices[body weight, waist aircumstance, body mass index (BMI) and waist-hit ratio (WHR)] were determined before and after treatment. The efficacy was evaluated.

RESULTSThe treatment course was completed in 95.71% of patients. The total effective rate of the 33 patients of the treatment group was 93.94% (31/33), while it was 91.18% (31/34) in the 34 patients of the control group. There was no difference in the total effective rate between the two groups (P > 0.05). Prolactin levels in both group after treatment were significantly lower than those of the baseline (P < 0.01). There was no significant difference in prolactin levels between the two groups after treatment (P > 0.05). Compared with before treatment, body weight, BMI, waist circumstance, and waist-hip ratio obviously decreased after treatment, showing significant difference when compared with the control group (P < 0.05). There was no significant difference in body weight, BMI, waist circumstance, and waist-hip ratio in the control group between before and after treatment (P > 0.05).

CONCLUSIONSBoth WP and aripiprazole could lower high prolactin levels of schizophrenics with phlegm dampness type amenorrhea. They showed equivalent efficacy. But WP showed more obvious effect in reducing obesity indices.

Aged ; Amenorrhea ; drug therapy ; Antipsychotic Agents ; administration & dosage ; adverse effects ; therapeutic use ; Aripiprazole ; Body Mass Index ; Body Weight ; Drug Therapy, Combination ; methods ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Galactorrhea ; drug therapy ; Humans ; Obesity ; Piperazines ; administration & dosage ; adverse effects ; therapeutic use ; Quinolones ; administration & dosage ; adverse effects ; therapeutic use ; Waist-Hip Ratio

OBJECTIVETo study the effect and safety of aripiprazole in the treatment of childhood autism.

METHODSThirty-five children (aged from 4 to 16 years) with autism presenting as behavioral disorders were treated with aripiprazole for 8 weeks. They were evaluated according to the Clinical Global Impression (CGI) and the Autism Treatment Evaluation Checklist (ATEC) before treatment and at the end of the 2nd, 4th and 8th weeks of treatment. Adverse reactions were observed.

RESULTSThe CGI showed illness severity decreased from the second week of aripiprazole treatment (P<0.05) and more significantly decreased illness severity was observed at the end of the 8th week (P<0.01). The curative effect score significantly increased at the end of the 8th week (P<0.05). The ATEC total scores were significantly reduced at the end of the 8th week after aripiprazole treatment. Besides the social intercourse ability, great improvements were shown in verbal communication, apperception and behavioural symptoms after aripiprazole treatment (P<0.01). Self-harm, sleep disorders and psychiatric symptoms were greatly improved after treatment and attention deficit, excessive activities, impulse to attack behavior, stereotyped behaviors and irritability were also improved to some extent. No severe adverse effects were found.

CONCLUSIONSAripiprazole is safe and effective for the treatment of childhood autism.

Adolescent ; Antipsychotic Agents ; therapeutic use ; Aripiprazole ; Autistic Disorder ; drug therapy ; Child ; Child, Preschool ; Female ; Humans ; Male ; Piperazines ; adverse effects ; therapeutic use ; Quinolones ; adverse effects ; therapeutic use

INTRODUCTIONThis study aimed to determine the prevalence of metabolic syndrome and risk of coronary heart disease (CHD) in patients with schizophrenia receiving antipsychotics in Malaysia.

METHODSThis cross-sectional study, conducted at multiple centres, involved 270 patients who fulfilled the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-TR diagnostic criteria for schizophrenia, were on antipsychotic medications for at least one year, and were screened for metabolic syndrome. Patients receiving mood stabilisers were excluded. Metabolic syndrome was defined according to the National Cholesterol Education Program ATP III criteria modified for Asian waist circumference. Risk for cardiovascular disease was assessed by using Framingham function (all ten-year CHD events).

RESULTSThe prevalence of metabolic syndrome was 46.7% (126/270). Among all the antipsychotics used, atypical antipsychotics (monotherapy) were most commonly used in both the metabolic and non-metabolic syndrome groups (50.8% vs. 58.3%). The ten-year risk for CHD was significantly higher in patients with metabolic syndrome. The proportion of patients with high/very high risk for CHD (Framingham ≥ 10%) was greater in patients with metabolic syndrome than in those with non-metabolic syndrome (31.5% vs. 11.0%, odds ratio 3.9, 95% confidence interval 2.0-7.6; p < 0.001). The mean body mass index was higher in patients with metabolic syndrome than in those without (29.4 ± 5.1 kg/m2 vs. 25.0 ± 5.6 kg/m2; p < 0.001).

CONCLUSIONPatients with schizophrenia receiving antipsychotics in Malaysia have a very high incidence of metabolic syndrome and increased cardiovascular risk. Urgent interventions are needed to combat these problems in patients.

Adolescent ; Adult ; Aged ; Antipsychotic Agents ; adverse effects ; therapeutic use ; Body Mass Index ; Cardiovascular Diseases ; epidemiology ; etiology ; Cross-Sectional Studies ; Female ; Humans ; Incidence ; Malaysia ; epidemiology ; Male ; Metabolic Syndrome ; epidemiology ; etiology ; Middle Aged ; Odds Ratio ; Prevalence ; Retrospective Studies ; Risk Factors ; Schizophrenia ; complications ; drug therapy ; epidemiology ; Young Adult

OBJECTIVE: To evaluate the efficacy and safety of risperidone versus traditional agents in treating Tourette's syndrome. METHODS: Randomized, controlled trials (RCTs) of risperidone versus traditional agents for Tourette's syndrome were identified, and eligible studies were included according to our established strategy. Besides methodological quality of inclusive trials, assessed by the Jadad scale, heterogeneity test, Meta-analysis, funnel plot analysis, subgroup analysis and sensitivity analysis were used to analyze the data. RESULTS: A total of 12 RCTs were included, with most trials of low methodological quality and high heterogeneity. Meta-analysis from 11 of the identified RCTs, involving total 741 patients, showed that there was no significant difference in efficacy between risperidone and traditional agents, based on the results of sensitivity analysis, and analyses of a haloperidol subgroup and a domesticforeign subgroup. The funnel plots was approximately symmetrical, indicating little publication bias. Risperidone presented mild side effects overall, including extrapyramidal symptoms (EPS), autonomic nervous system symptoms, toxic reactions and the Treatment Emergent Symptom Scale (TESS) score of the treatment group were significantly less than those of control. CONCLUSION Risperidone appears to have the same efficacy and appropriate safety as traditional agents in treating Tourette's syndrome. Because of the low validity of the results, we are searching for support from the more RCTs with higher methodological quality.
Antipsychotic Agents ; adverse effects ; therapeutic use ; Humans ; Randomized Controlled Trials as Topic ; Risperidone ; adverse effects ; therapeutic use ; Tourette Syndrome ; drug therapy

OBJECTIVETo study the effect of risperidone treatment on behavioral disorders in children with autism.

METHODSForty children with behavioral disorders (aged from 5 to 12 years) were treated with risperidone for 8 weeks. The behavioral symptoms were evaluated by the Clinical Global Impression (CGI) and the Autism Treatment Evaluation Checklist (ATEC) before and after the treatment. The adverse events related to risperidone treatment were observed.

RESULTSThe score of severity of illness and the ATEC total scores were significantly reduced 8 weeks after risperidone treatment. Besides the social intercourse ability, great improvements have been shown on the verbal communication, apperception and behavioural symptoms by the ATEC. No severe adverse events related to risperidone treatment were observed.

CONCLUSIONSRisperidone can significantly improve the behavioral disorders in children with autism and is well-tolerated.

Antipsychotic Agents ; therapeutic use ; Autistic Disorder ; drug therapy ; psychology ; Child ; Child Behavior Disorders ; drug therapy ; Child, Preschool ; Female ; Humans ; Male ; Risperidone ; adverse effects ; therapeutic use

PURPOSE: This study was done to identify some natural meaning through the dosage experience of psychoactive drugs in women patients with schizophrenia. METHODS: The Hermeneutic phenomenology written by van Manen was used. The period for data collection was from November 2009 to January 2010. This study took place in mental health hospitals and mental health centers in two cities in North Jeolla Province. Nine patients with schizophrenia participated. Data collection was done through individual in-depth interview. RESULTS: The seven natural subjects demonstrated by participants from this study were 'Pills forcibly taken like veiled threats', 'A terrible side effect, a side effect rooted slowly', 'Shame which cannot be hidden as a woman', 'A bad medicine took away from motherhood', 'The fate of a wife who can't be equal', 'A struggle for the complete recovery without promise', and 'Participants want the future without medicine'. CONCLUSION: The results of this study indicate that the urgent need to develop a safe and believable psychoactive drug for woman patients considering the time of menstruation, pregnancy, childbirth, and child raising.
Adult ; Antipsychotic Agents/adverse effects/*therapeutic use ; Female ; Humans ; Interviews as Topic ; Middle Aged ; Patient Compliance/psychology ; Quality of Life ; Schizophrenia/*drug therapy