Adult Schizophrenia Research Study: The NIMH Genetic Study of Schizophrenia

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Individuals or their family members that are aged 18 or older and have been diagnosed with schizophrenia or schizoaffective disorder (depressed type) may be able to participate in a genetic study that looks for genes in families. In order for family members to participate, the person with schizophrenia must be willing and able to participate. Eligible family members participate in an interview and contribute a sample of blood for genetic analysis. Individuals with schizophrenia and, if possible, their siblings may qualify to participate in this study. There is no change in medication involved. The study involves simple cognitive tests and some MRI scans (no radiation). All testing is completed free of charge and there is compensation for each family member’s participation in the study. Travel and lodging assistance is also available. Scientists believe that the identification of susceptibility genes is key to understanding the molecular pathways of this disease so that better treatments and preventive methods can be developed in the future. To learn more details, please call 301-435-8970 (1-888-674-6464) or email at schizophrenia@mail.nih.gov.
For more information on research conducted by the National Institute of Mental Health in Bethesda, MD click here http://patientinfo.nimh.nih.gov

PEER SUPPORT MAY REDUCE DEPRESSION SYMPTOM BETTER THAN TRADITIONAL CARE

Peer support appears to be a low-cost and effective way to reduce depression symptoms, a new study finds. Programs in which patients received support from volunteers were found to reduce depression symptoms better than traditional care alone and were about as effective as cognitive behavioral therapy, the researchers found. Reported online in the journal General Hospital Psychiatry, the researchers note that peer support has been found to decrease isolation, reduce stress, increase the sharing of health information and provide role models. Peer support programs may also empower patients to play a more active role in their own self-care, they write. (HealthDay News, 2/18/11)

Aide to Giffords Starts Fund to Promote Mental Health Awareness

A congressional aide who was shot in last month’s attack in Arizona that killed six and left U.S. Rep. Gabrielle Giffords and 12 others wounded has announced a fund to promote mental health awareness and civility. Ron Barber, Giffords’ district director, said that he wants to fund programs in schools and the community that will take some of the stigma away from mental illness. The Fund for Civility, Respect and Understanding was started with an undisclosed donation from Barber’s family. (Associated Press, 2/17/11)

Antipsychotics Tied to Brain Volume Loss in Schizophrenia

A new study shows patients with schizophrenia receiving antipsychotic medication may lose a small, but measurable, amount of brain tissue over time. Patients who take the largest doses over the longest duration of time are apt to see the greatest declines, new research suggests.

Illness duration and severity were also associated with brain volume loss, but the association between antipsychotic drug use and brain volume remained significant after accounting for these factors. The volume losses occurred in gray matter and white matter.

“The clinical significance of these findings is extremely difficult to fully assess,” study investigator Beng-Choon Ho, MD, MRCPsych, told Medscape Medical News. “To achieve this will require randomized controlled studies involving schizophrenia patients and healthy controls, but such studies do not meet current ethical standards in research.”

Dr. Ho, from the University of Iowa Carver College of Medicine in Iowa City, said it’s “important for clinicians to work with schizophrenia patients so as to find the minimum effective antipsychotic dosage for each individual patient.” However, the findings do not support monitoring of patients by using follow-up brain imaging, he added.

The findings are reported in the February issue of the Archives of General Psychiatry….

By Megan Brooks
Medscape Medical News
http://www.medscape.com/viewarticle/737240
Arch Gen Psych. 2011;165:126-137. Abstract

Risperidone Noncompliance Causes Quick Return of Positive Schizophrenia Symptoms

NEW YORK (Reuters Health) Jan 27 – Among recent-onset schizophrenia patients prescribed risperidone, nonadherence rapidly leads to the return of positive symptoms, researchers report in a January 4th online paper in the American Journal of Psychiatry.

“Something that was quite striking in this study was that even brief periods of partial nonadherence lead to greater risk of relapse than what is commonly assumed,” Dr. Kenneth L. Subotnik, told Reuters Health by email.

“Schizophrenia patients often lack insight into the continued need for antipsychotic medication and either covertly or overtly stop taking some or all of their medication. This is a common clinical situation in outpatient treatment,” he pointed out.

Dr. Subotnik of the University of California, Los Angeles and colleagues studied 49 patients. The degree of antipsychotic medication adherence was rated weekly for up to 18 months following initial outpatient stabilization on risperidone.

Nondetectable levels of 9-hydroxyrisperidone were used to flag nonadherence.

Overall, 32% were considered adherent; 33% had a period of mild nonadherence. Moderate (16%) and severe (19%) nonadherence were relatively less common.

During follow-up, 13 patients had a return of psychotic symptoms meeting exacerbation or relapse criteria.

Compliance with only 50% to 75% of the prescribed medication for 2 or more consecutive weeks was associated with the return of psychotic symptoms (hazard ratio, 5.8).

“The effect of moderate nonadherence (compliance with less than 50% of the medication for more than 2 weeks but less than 4 weeks) was even more striking (hazard ratio 28.5),” say the authors, supporting the view that even partial medication nonadherence has deleterious effects.

The mean time from the beginning of nonadherence until relapse was about 2.5 months.

The researchers also came to similar conclusions when they employed alternative definitions of medication nonadherence.

Given these findings, concluded Dr. Subotnik, “Patients in the early phase of schizophrenia should be cautioned about the possible consequences of partial or relatively brief periods of antipsychotic medication nonadherence.”

By David Douglas
Reuters Health Information

Am J Psychiatry. Posted online January 4, 2011. Abstract

Inhaled Loxapine Eases Acute Psychotic Agitation

NEW YORK (Reuters Health) Feb 02 – Loxapine inhaled through a new device effectively controls agitation in patients with schizophrenia, according to findings published online in the January 25th Journal of Clinical Psychiatry.

“This is a very simple device,” Dr. Michael H. Allen from University of Colorado Depression Center, Aurora, Colorado told Reuters Health by email.

“If you can breathe, you can use it. At the more severe end of the agitation spectrum, all but the most hostile, agitated patients can use it and will prefer it to injection. We hope that it will lead to fewer episodes of restraint and seclusion by offering a rapid alternative to forcible treatment.”

Dr. Allen and colleagues assessed the efficacy and safety of a single dose of loxapine delivered as a thermally generated aerosol in 129 agitated patients with schizophrenia or schizoaffective disorder. The current episode of agitation had lasted about a week.

The 10-mg inhaled dose of loxapine provided significantly greater improvement in the primary endpoint (Positive and Negative Syndrome Scale-excited component, PANSS-EC) at 2 hours than did placebo, whereas there was only a trend toward greater improvement with the 5-mg inhaled dose.

The superiority of PANSS-EC scores in the 10-mg group emerged 20 minutes after dosing and the trend of superiority in the 5-mg group was apparent 45 minutes after inhalation.

Results were similar for secondary outcomes of Clinical Global Impressions-Improvement scale (CGI-I) and Behavioral Activity Rating Scale (BARS).

Moreover, both doses of inhaled loxapine significantly prolonged the time to administration of first rescue medication and significantly reduced the use of rescue medication.

Adverse events occurred in a similar percentage of patients in the 5-mg group (14/45, 31%), 10-mg group (16/41, 39%), and placebo group (14/43, 33%), with dysgeusia, sedation, and dizziness being most frequently reported. None of the patients withdrew from the study because of adverse events.

“We think one of the major pluses of this device is that it literally puts more control in the hands of consumers,” Dr. Allen said. “Staff show them how to use it rather than holding them down and forcing it on them. This is huge because many of our patients have been previously victimized and the symbolism of the injection method triggers traumatic memories. The Staccato device (Alexza Pharmaceuticals, Inc.) allows more of a partnership with the patient and a brief wait for results.”

“The company has focused on the delivery device, not the drugs per se, and their efforts are devoted to proofs of concept for other drugs in other disease states,” Dr. Allen said. “We just happened to have the most rapid success with the loxapine for agitation example of this model.”

Four of the 8 authors have served as consultants or speakers or have received grant/research support from Alexza, which funded the study. Two other authors are employees of and stock shareholders in Alexza.

By Will Boggs MD
Reuters Health Information

NIMH OUTREACH PARTNERSHIP PROGRAM UPDATE for March1, 2011

The Outreach Partnership Program a nationwide outreach initiative of the National Institute of Mental Health (NIMH) that enlists state and national organizations in a partnership to help close the gap between mental health research and clinical practice, inform the public about mental illnesses, and reduce the stigma and discrimination associated with mental illness. For more information about the program please visit: http://www.nimh.nih.gov/outreach/partners. To subscribe to receive the Update every two weeks, go to: http://www.nimh.nih.gov/outreach/partnership-program/subscribe-to-the-update.shtml

The information provided in the Update is intended for use by NIMH Outreach Partners, National Partners and their associates for the express purpose of exchanging information that may be useful in the development of state and local mental health outreach, information, education and partnership programs.

NIMH_Update_3-1-11

Frequent Cocaine Use Linked to Alterations in DNA: Findings May Provide Insight Into Underlying Mechanisms of Addictive Behavior

Regular cocaine use can affect DNA transcription networks and chromatin remodeling across the genome, according to a new study published online February 7 in Proceedings of the National Academy of Sciences of the United States of America.

The study suggests that derepressing parts of the genome by cocaine use can alter patterns of gene transcription in specific neuron types, affecting their drug sensitivity……..

Jacquelyn K. Beals, PhD
Medscape Medical News
http://www.medscape.com/viewarticle/737033

Schizophrenia Gene Mutation Discovered: Findings Renew Hope for the Development of New, More Effective Drugs

Scientists have discovered a gene mutation that is strongly linked to schizophrenia and a signalling pathway that may be treatable with existing drugs.

“This discovery is the latest in a series of studies by our group and by others that have changed the tables in terms of genetic studies in schizophrenia,” Jonathan Sebat, PhD, assistant professor of psychiatry and cellular and molecular medicine at the University of California (UC), San Diego, who led the team that made the discovery, told Medscape Medical News.

“Mutations in the VIPR2 gene, which can be found in about 1 in 300 patients, are responsible for some amount of schizophrenia, but the fact that this mutation is rare does not necessarily diminish its importance because this is a drug-able gene,” he said………

Fran Lowry
Medscape Medical News
http://www.medscape.com/viewarticle/736798

SZ Magazine: A Free Electronic Newsletters Specific to Schizophrenia, Bipolar Disorder, or Depression

Looking for more information? Sign up today for one of our Free electronic newsletters specific to schizophrenia, bipolar disorder, or depression. These newsletters provide you with the latest news and information from around the world specifically about each illness and are delivered directly to your email inbox every month.

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