Amisulpride vs Olanzapine in Indian Schizophrenic patients

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This is my MD thesis work.

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Amisulpride versus Olanzapine in treatment of schizophrenia in Indian patients-A Randomized Controlled Trial Dr Subhrojyoti Bhowmick 1 Dr Avijit Hazra 1 & Prof Malati Ghosh 2 Department of Pharmacology 1 Institute of Postgraduate Medical Education & Research, Kolkata – 700020 Department of Psychiatry 2 Bangur Institute of Neuroscience & Psychiatry, Kolkata-700025

[object Object],[object Object],[object Object],[object Object],Introduction Amisulpride

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[object Object],[object Object],[object Object],[object Object],[object Object],Materials & Methods 1

[object Object],[object Object],[object Object],Materials & Methods 2 EFFICACY VARIABLES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],Materials & Methods 3

Results Study groups were comparable at baseline with respect to age, sex, baseline BPRS, SANS & SAPS scores. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Results-Efficacy Changes in the BPRS scores during study Values are as Mean  Standard deviation Time point Amisulpride (n= 39) Olanzapine (n=38) p value Baseline 62.66 ± 5.16 61.21 ± 5.13 NS At 4 w 56.79 ± 6.07 53.07 ± 6.57 0.012 At 8 w 47.74 ± 6.25 43.57 ± 7.03 0.007 At 12 w 37.65 ± 9.67 33.18 ± 9.44 0.044

[object Object],Changes in SANS & SAPS scores Amisulpride Olanzapine

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Results - Adverse events

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Discussion 1

[object Object],[object Object],[object Object],[object Object],Discussion 2 ,[object Object],[object Object],[object Object],[object Object],Study limitations

[object Object],Conclusion Improvement more with Olanzapine in BPRS score reduction Amisulpride to be a secondary choice in limited extent, such as to avoid problems like weight gain or excessive sedation

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The aim of this study was to investigate the long-term effect of selective laser trabeculoplasty in open angle glaucoma patients as a replacement for medical therapy. 64 eyes of 64 primary open angle glaucoma (POAG) patients under therapy with glaucoma drugs and controlled Intra Ocular Pressure (IOP) were reviewed for 36 months. 360o selective laser therapy (SLT) sessions were performed in two sessions and the medical therapy was stopped. The patients were controlled and evaluated postoperatively 1, 3, 6, 12, 24 and 36 months after surgery for glaucoma progression. In 36 (56.3%) of the 64 patients SLT was successful and there was no need to medical treatment at 36th month. In 28 patients (43.7%) medical treatment was started due to IOP rising. In Logistic regression analysis baseline IOP was found to be significantly effective on success rate of SLT (R2: 0.718, p<0.001).

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Cognitive Effects of Risperidone in Children with Autism and Irritable Behavior Abstract Objective: The objective of this research was to explore the effects of risperidone on cognitive processes in children with autism and irritable behavior. Method: Thirty-eight children, ages 5–17 years with autism and severe behavioral disturbance, were randomly assigned to risperidone (0.5 to 3.5 mg/day) or placebo for 8 weeks. This sample of 38 was a subset of 101 subjects who participated in the clinical trial; 63 were unable to perform the cognitive tasks. A double-blind placebocontrolled parallel groups design was used. Dependent measures included tests of sustained attention, verbal learning, hand-eye coordination, and spatial memory assessed before, during, and after the 8-week treatment. Changes in performance were compared by repeated measures ANOVA. Results: Twenty-nine boys and 9 girls with autism and severe behavioral disturbance and a mental age 18 months completed the cognitive part of the study. No decline in performance occurred with risperidone. Performance on a cancellation task (number of correct detections) and a verbal learning task (word recognition) was better on risperidone than on placebo (without correction for multiplicity). Equivocal improvement also occurred on a spatial memory task. There were no significant differences between treatment conditions on the Purdue Pegboard (hand-eye coordination) task or the Analog Classroom Task (timed math test). Conclusion: Risperidone given to children with autism at doses up to 3.5 mg for up to 8 weeks appears to have no detrimental effect on cognitive performance. Introduction LITERATURE FOCUSING ON the cognitive effects of atypical antipsychotics in children and adolescents is exceptionally sparse. The bulk of the literature currently comes from studies of adults with schizophrenia; in addition there are a few investigations with patients having Alzheimer’s disease. Given that antipsychotics often cause sedation, many investigators and clinicians have wondered if cognitive blunting and/or sedation accompanying early treatment may impair cognition (Ernst et al. 1998; Aman 1984; Aman et al. 1991). The possibility of cognitive impairment seems likely in the short term, as somnolence is a frequent side effect of atypical antipsychotics, especially early in treatment. However, a detailed analysis of adverse events from risperidone treatment in children with autism indicated that reports of somnolence usually dissipated between 2 and 4 weeks after the last dose adjustment of risperidone (Aman et al. 2005). Thus it seems that the time of greatest “risk” of cognitive impairment would be in the earliest weeks of treatment. Literature from adult trials in schizophrenia, have provided us with some insight into the cognitive effects of these drugs. Keefe et al. (1999) conducted a review of 15 studies in which adult patients with schizophrenia were assessed for cognitive effects while taking at.

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