Background: Polypharmacy for schizophrenia treatment is not justified by the available clinical evidence. We evaluated a treatment reduction approach that reduces the dose and number of antipsychotic medications simultaneously prescribed to patients.
Methods: In a randomized open study of the Safe Correction of Antipsychotic Polypharmacy and High-Dose Prescriptions program funded by the Japanese Ministry of Health, Labour, and Welfare, we evaluated a drug reduction method consisting of a dose reduction intervention performed on 163 patients with schizophrenia for twelve or 24 weeks. One antipsychotic medication was removed each week from each patient's treatment regimen by reducing the dose by 0 to 50 chlorpromazine equivalents. Data on health-related indices of quality of life, clinical symptoms, and risk of side effects were analyzed using a two-way repeated-measures mixed linear model.
Results: Despite a 23% reduction in antipsychotic dose, no differences in outcomes were observed between the dose reduction and observation groups (effect size = 0.001 - 0.085, P = .24-.97), despite high statistical power (1-β = 0.48-0.97). The findings are limited by the nonuniformity of the participants' treatment history, duration, and dose reduction amount. Dose reduction protocol patients exhibited no difference in psychotic symptoms or adverse events compared with the observation group.
Conclusions: Importantly, the low dropout rate in our study (6.9% of participants withdrew because of patient factors and 23.8% for all secondary reasons) indicates that our "slowly" method is well tolerated. We hope that this approach will result in therapeutic improvements.
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http://dx.doi.org/10.1093/ijnp/pyu016 | DOI Listing |
World J Diabetes
January 2025
Department of Endocrinology, Beijing Haidian Hospital, Beijing 100080, China.
Background: Treating diabetes in dialysis patients remains a challenge, with many hypoglycemic drugs requiring dose adjustments or avoidance in these patients.
Case Summary: This report describes an 83-year-old female patient with a 30-year history of type 2 diabetes (T2DM) who had struggled to control her blood sugar for more than a year. She had a history of high blood pressure for 30 years, had undergone continuous ambulatory peritoneal dialysis for more than two years, was 163 cm tall, weighed 77 kg, and had a body mass index of 28.
Background: The most effective way to treat patients following a first ICD therapy is unclear. We hypothesised that following first ICD therapy, combining different treatment strategies would be associated with a reduction in the risk of subsequent therapy compared to single strategies alone.
Methods: Data was collected from consecutive patients undergoing ICD implantation at King's College Hospital between January 2009 and December 2019.
Ecancermedicalscience
November 2024
Department of Palliative Medicine, Mahamana Pandit Madan Mohan Malaviya Cancer Centre and Homi Bhabha Cancer Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Varanasi 221005, India.
Background: Metastatic breast cancer (MBC) patients have numerous options for treatment. However, it is essential to consider treatments with favorable toxicity profiles and convenient modes of administration. Eribulin has shown effectiveness in aggressive MBC, but there is a lack of sufficient real-world data specific to Indian patients.
View Article and Find Full Text PDFInt J Nanomedicine
January 2025
Division of Microbiology, National Center for Toxicological Research, US Food and Drug Administration, Jefferson, AR, 72079, USA.
Poor aqueous solubility and bioavailability limit the translation of new drug candidates into clinical applications. Nanocrystal formulations offer a promising approach for improving the dissolution rate and saturation solubility. These formulations are applicable for various routes of administration, with each presenting unique opportunities and challenges posed by the physiological barriers.
View Article and Find Full Text PDFCureus
December 2024
Department of Oral Medicine and Radiology, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Vijayawada, IND.
Background The thyroid gland is the most susceptible organ to radiation during the exposure of teeth because the thyroid area appears to be within the primary beam, and the dose levels are relatively high even after using collimation. This study aims to develop an eco-friendly thyroid shield by reusing lead foils from intra-oral periapical radiographic films and evaluate its effectiveness in intraoral radiography. Methods A total of 16 patients undergoing endodontic procedures who gave written consent to participate in the study were included and divided into four categories: anterior, canine, premolar, and molar.
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