WHAT WE DO
WAIST
Weight Assessment and
Intervention in Schizophrenia Treatment
In this study, we are examining the long-term efficacy of a behavioral treatment for weight reduction in patients with schizophrenia or schizoaffective disorder. Two-thirds of our patients are randomly assigned to receive behavioral treatment for weight reduction, while the remaining third are randomly assigned to receive either social skills training for weight reduction or usual care. We are focused on health and weight reduction because the evidence shows us that the heavier a person is, the greater chance s/he will suffer from at least one serious health impairment. Furthermore, studies have shown us that people with schizophrenia are more likely to be overweight and obese. Check out the facts .
Overweight and Obese
Individuals are at Risk for:
High blood
pressure
Gout
High
cholesterol
Osteoarthritis
Type 2
diabetes
Some types of cancer
Coronary Heart
Disease
Sleep apnea and respiratory problems
Stroke
Congestive
Heart Failure
Gallstones
Schizophrenia and Weight Gain
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In a recent survey we conducted of body weight, BMI (body mass index) and nutritional habits in our patients with schizophrenia, 60% in the study were obese (BMI>30) and 22% were overweight (BMI 25-30). These rates are higher than in the general population where the rates of obesity are around 20%. |
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There is considerable evidence that treatment with Second Generation Antipsychotics "can cause a rapid increase in body weight" ( Diabetes Care, February 2004). |
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Even before the the introduction of antipsychotics, there is documentation that patients with schizophrenia gained weight.
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Studies completed in the UK
have shown that patients with schizophrenia eat foods high in fat and
low in fiber and vitamins as compared to the general population (McCreadie
et al., 1998). Other studies have also concluded that obesity in schizophrenia
may primarily result from poor dietary choices ( Brown et al, 1999). We have
also observed that patients with schizophrenia consume more food and therefore
calories than their age and gender in the general population. |
Well-Being Study
In this study, we are proposing that the use of a statin, in this case Pravastatin, in conjunction with the subjects' usual atypical antipsychotic, will reduce the positive and negative symptoms of schizophrenia or schizoaffective disorder. We also propose that subjects' cognitive functioning and social functioning will significantly improve over the group treated with placebo.
Statins
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It has been suggested that statins may not only lower cholesterol, but also improve other chronic conditions such as osteoporosis, multiple sclerosis and dementia. |
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Statins improve endothelial function and may improve blood flow by relaxing the small vessels in the brain. |
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Statins decrease inflammation, which correlates to reducing cardiovascular risks. |
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Anti-inflammatory effects may also prevent dementia, especially in Alzheimer's disease. |
Statins and Schizophrenia:
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Abnormalities in levels of immuno-inflammatory markers have been shown in people with schizophrenia. A decrease in these levels is associated with an improvement in their clinical state. |
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It is believed that there will be improvements in stress, depression, anger, cognitive function, and general well-being associated with statin treatment. |
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Not only will Pravastatin help in lowering positive and negative symptoms of Schizophrenia, but will aid in controlling obesity. |
SAMMI
Study
Sociability,
Attention, Mood, Motivation, and Interest 
In this study we are examining the effect of Atomoxetine, a selective norepinephrine reuptake inhibitor (SNRI) on negative symptoms and quality of life, and also its safety when used in conjunction with an atypical antipsychotic. We believe that subjects treated with Atomoxetine will have a significant greater improvement in quality of life and social functioning than the subjects treated with placebo.
Atomoxetine:
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Atomoxetine was recently approved by the FDA for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in children and adults. |
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It is believed to act by either blocking or slowly reabsorbing norepinephrine in the prefrontal cortex, thereby increasing its concentration. |
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Abnormalities of the prefrontal cortex have been implicated in the development of negative symptoms in schizophrenia. |
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Therefore, Atomoxetine may have a therapeutic role to play in resolving negative symptoms. |
Atomoxetine and Schizophrenia:
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Negative symptoms in schizophrenia include apathy, social withdrawal, poverty of thinking, and lack of drive and motivation. These are perhaps the most disabling parts of the illness. |
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Most atypical antipsychotics provide some improvement in negative symptoms, though these improvements are disappointingly small. |
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Negative symptoms are often strong predictors of poor social functioning and quality of life. |
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Social disabilities from negative symptoms continue to persist today. |