Liraglutide Decreased Body Weight, Improved Glucose Tolerance and Cardio Health in Schizophrenia

December 18, 2017 · Posted in Potential Treatments · Comment 

weightA 2017 article by Julie R. Larsen and colleagues in the journal Archives of General Psychiatry reported that the drug liraglutide, a treatment for type 2 diabetes, improved certain health measures in people with schizophrenia who were overweight and prediabetic and being treated with the atypical antipsychotics olanzepine or clozapine.

In the 16-week trial, patients received a daily 2 mg injection of liraglutide under the skin or placebo. Liraglutide decreased body weight, improved glucose tolerance, and improved cardio-metabolic measures. Weight decreased by more than 10 pounds on average compared to placebo.

Liraglutide is derived from a human metabolic hormone. It binds to the same receptors as does the metabolic hormone GLP-1, which stimulates insulin secretion.

Solutions for Clozapine-Induced Drooling

July 20, 2015 · Posted in Current Treatments · Comment 

 

drooling while sleeping

Clozapine is a treatment for schizophrenia and treatment-resistant bipolar disorder. Drooling is a side effect for about one-third of people taking clozapine. Here are some treatments that may help reduce it:

 

1) Botox injected into each salivary (parotid) gland in doses of 50 IU.

2) Ipratropium, either sprayed under the tongue or intranasally. A 2004 case series by Oliver Freudenreich in the Journal of Clinical Psychiatry described sublingual administration.

3) Glycopyrrolate. In a 2011 article in the Annals of Pharmacotherapy, AM Bird described some treatments for clozapine-induced drooling, including glycopyrrolate.

4) The blood pressure drugs clonidine (50–100 mg) or terazosin.

4) Transdermal scopolamine patch. This is typically placed behind the ear to reduce motion sickness, but it also reduces saliva production.

 

 

 

Clozapine-Induced Myocarditis More Common Than Thought

June 29, 2015 · Posted in Current Treatments · Comment 

heartNew research indicates that myocarditis, inflammation of the middle layer of the heart wall, occurs in about 3% of patients who begin taking clozapine (Clozaril). Researcher Kathlyn J. Ronaldson and colleagues recently published research to this effect in the journal Acta Psychiatrica Scandinavica. Many cases of myocarditis, which can be fatal, begin with fever. Other symptoms include rapid or abnormal heart rhythms, shortness of breath, fluid retention, and fatigue. Because the illness resembles a viral infection, it may be misdiagnosed.

In 2010 Ronaldson and colleagues reported in the Journal of Clinical Psychiatry that tachycardia (rapid resting heart rate) and elevated levels of a group of proteins knows as troponin in the blood are almost always present during the first 45 days of treatment in patients who develop myocarditis. The researchers found that the time to onset of myocarditis was 14 to 22 days in almost all cases. Eosinophilia (high levels of a certain type of white blood cell) may occur in the week after peak troponin levels, and high levels of the inflammatory protein CRP (above 100mg/L) occurred in 79% of cases.

Ronaldson and colleagues suggest that patients who are prescribed clozapine be monitored for myocarditis during the first four weeks of treatment, particularly during the third week.