6 research outputs found
The relationship between physical and mental health: an update from the WPA Working Group on Managing Comorbidity of Mental and Physical Health
No full textREMISSION AND EMPLOYMENT STATUS IN SCHIZOPHRENIA AND OTHER PSYCHOSES: ONE-YEAR PROSPECTIVE STUDY IN CROATIAN PATIENTS TREATED WITH RISPERIDONE LONG ACTING INJECTION
No full textBackground: While numerous studies have confirmed the efficacy of risperidone long-acting injectable (RLAI) on many clinical
outcomes in patients with schizophrenia, there is no data regarding its influence on employment status.
Subject and methods: This was a 12-month observational study with flexible doses of RLAI on a Croatian population of patients
with schizophrenia and other psychoses. Visits were at baseline and after 1, 3, 6 and 12 months of treatment. Treatment response
was evaluated using Clinical Global Impression of Illness Severity (CGI-S) and Improvement (CGI-I) scales, while remission was
defined by 8 items of Positive and Negative Syndrome Scale (PANSS). Employment status was determined at baseline and at study
endpoint.
Results: A total of 362 patients were included, with a median age of 37 (interquartile range 29-47) years, 63.5 % were males and
67.4% were hospitalised at baseline. Overall 258 (71.3%) patients completed the study. Improvements in CGI-S scores from baseline
were significant (
EFFICACY, SAFETY AND TOLERABILITY OF AUGMENTATIVE rTMS IN TREATMENT OF MAJOR DEPRESSIVE DISORDER (MDD): A PROSPECTIVE COHORT STUDY IN CROATIA
No full textEFFICACY AND SAFETY OF REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION USING AN H1-COIL OR FIGURE-8-COIL IN THE TREATMENT OF UNIPOLAR MAJOR DEPRESSIVE DISORDER: A STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL
No full textEFFICACY, SAFETY AND TOLERABILITY OF AUGMENTATIVE rTMS IN TREATMENT OF MAJOR DEPRESSIVE DISORDER (MDD): A PROSPECTIVE COHORT STUDY IN CROATIA
No full textBackground: An increasing body of research suggest that repetitive Transcranial Magnetic Stimulation (rTMS) is effective and
safe treatment option for patients with major depressive disorder (MDD). The Psychiatric Hospital “Sveti Ivan“has the first TMS
laboratory with rTMS and deep TMS (dTMS) in Croatia. The objective of this study was to assess the efficacy, safety and tolerability
of augmentative rTMS treatment vs standard treatment in Croatian patients with major depressive disorder (MDD).
Subjects and methods: Total of 93 MDD patients were enrolled; 41 of them were treated by augmentative rTMS and 52 were
treated by standard (psychopharmacotherapy and psychotherapy) therapy only. We delivered rTMS to the left dorsolateral
prefrontal cortex at 120% motor threshold (10 Hz, 4-second train duration), 3000 pulses per session using a figure-eight coil,
minimum of 20 sessions during four weeks. Our key outcome was the change in Hamilton Depression Scale (HAM-D17) result from
baseline to 4th week. Our secondary outcomes were changes in Hamilton Anxiety (HAM-A) and WHOQOL-BREF scales.
Results: After four weeks the changes of HAM-D17 and HAM-A results were significantly different between the group of patients
treated by augmentative rTMS (48% and 53% decrease, respectively) and the group of patients treated by the standard therapy alone
(24% and 30% decrease) (P=0.004, P=0.007). Absolute benefit increase defined as the difference between rates of remission (HAMD17
≤7) in rTMS and control group was 33% (P=0.001). Number of patients needed to treat with rTMS in order to achieve
remission in one patient was NNT=3. In a group of patients treated with augmentative rTMS 21/41 (51%), and in control group
17/52 (33%) were responders (P=0.071).
Conclusions: It seems that augmentative treatment with rTMS is more effective on depression and anxiety symptoms than
standard therapy in MDD with equal safety and tolerability. Randomized, controlled studies are required to verify this finding
The time has come for revising the rules of clozapine blood monitoring in Europe : a joint expert statement from the European Clozapine Task Force
No full textAbstract: The European Clozapine Task Force is a group of psychiatrists and pharmacologists practicing in 18 countries under European Medicines Agency (EMA) regulation, who are deeply concerned about the underuse of clozapine in European countries. Although clozapine is the most effective antipsychotic for people with treatment-resistant schizophrenia, a large proportion of them do not have access to this treatment. Concerns about clozapine-induced agranulocytosis and stringent blood monitoring rules are major barriers to clozapine prescribing and use. There is a growing body of evidence that the incidence of clozapine-induced agranulocytosis is very low after the first year of treatment. Maintaining lifelong monthly blood monitoring after this period contributes to unjustified discontinuation of clozapine. We leverage recent and replicated evidence on the long-term safety of clozapine to call for the revision and updating of the EMA's blood monitoring rules, thus aiming to overcome this major barrier to clozapine prescribing and use. We believe the time has come for relaxing the rules without increasing the risks for people using clozapine in Europe
