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Biomedical subjects

Gábor Faludi

Publications and source records attributed to Gábor Faludi.

7 recordsLinked to original sources
PubMed2006

[Switching patients with schizophrenia to ziprasidone from conventional or other atypical antipsychotics].

OBJECTIVES: The aim of the study was to assess the efficacy, tolerability and safety of ziprasidone in patients with schizophrenia who were already treated with conventional or other atypical antipsychotics that had to be switched due the lack of efficacy or bad tolerance. METHODS: The study was a 12-week, open label, multicenter, non comparative trial on oral ziprasidone. 106 patients with DSM-IV schizophrenia were switched to ziprasidone from their previous antipsychotic without a washout phase. The study required fixed dosing with ziprasidone. For the first week the patient received 80 mg of study drug daily, followed for 3 weeks 120 mg/day. Subsequently for 8 weeks either 80 mg, or 120 mg, or 160 mg total daily dose could be given at the discretion of the investigator. Baseline and outcome assessment included Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression Severity of Illness Subscale (CGI-S) and Global Improvement Subscale (CGI-I), Calgary Depression Scale (CAD), Hamilton Depression Scale (HAMD), Drug Attitude Inventory (DAI), Simpson Angus Extrapyramidal Symptoms Rating Scale (SAS) and Barnes Akathisia Rating Scale (BARS). Changes in overall body weight were also evaluated. RESULTS: After 12 weeks on ziprasidone therapy, significant improvements were observed on all major symptoms measures and subscales. 34 (51,5%) patients (ITT) were rated much or very much improved on CGI-I at week 12. The mean SAS score significantly reduced during the ziprasidone treatment period (p<0.001). In the DAI ziprasidone treatment was also favorable rated. During treatment with ziprasidone for 12 weeks the body weight of the patients was significantly reduced (mean: 1,2 kg, SD=3,79, p=0.002). 58 adverse events occurred in 41 subjects (38.7%), of whom 7 patients (6.6%) encountered 9 severe adverse events. The adverse events were mainly mild and moderate. 15 patients (14.2%) were discontinued from the study due to adverse events. The reason for discontinuation in 4 cases was mainly insufficient clinical response. CONCLUSION: Switching patients from their previous antipsychotic to ziprasidone without a washout phase was generally well tolerated and was associated with symptoms improvements 12 weeks later. At least 50% of patients who needed to be switched because of unsatisfactory efficacy or poor tolerance were significantly improved on ziprasidone therapy. The favorable safety profile of ziprasidone treatment was consistent with that seen in other clinical trials. KEYWORDS: switching, ziprasidone, schizophrenia.

Adult↗
PubMed2005

[The first long-acting atypical antipsychotic: new milestone in the treatment of schizophrenia].

Schizophrenia is a major chronic psychiatric disorder associated with significant impairment in psychosocial functioning and reduced quality of life. The major goals of current pharmacotherapy for schizophrenia are to achieve continuous relief from psychotic symptoms, to reduce relapse rates, and to provide maximal patient functioning and improved quality of life. To attain these goals, treatment needs to be effective, safe, and well tolerated. It is now generally accepted that the use of second generation or atypical antipsychotics for schizophrenia represents and advance over conventional antipsychotics. However, therapeutic compliance continues to be a major problems of the maintenance treatment. The long-acting conventional injectable antipsychotics might increase compliance, but they have become unpopular, largely because of the associated adverse events--akathisia, akinesia, and weight gain. Long-acting risperidone is the first atypical antipsychotic to be available in a long-acting formulation, which combines the benefits of risperidone with the advantages of a long-acting injection. It is dosed at 25-50 mg every 2 weeks. Available data on long acting atypical risperidone suggest that it is safe, efficacious and well tolerated. Long acting risperidone initiated during inpatient and outpatient treatment may be an important strategy in improving long-term outcomes among patients with schizophrenia. This article provides practical advice to physicians on he characteristics of patients who would benefit from treatment with long acting atypical antipsychotic agent and offers suggestions on how to initiate treatment.

Antipsychotic Agents↗
PubMed2005

[Possible connection between ghrelin, resistin and TNF-alpha levels and the metabolic syndrome caused by atypical antipsychotics].

Second generation antipsychotics (SGA) are obesitogenic and diabetogenic. Role of ghrelin (RIA), resistin and TNF-alpha (ELISA) in weight gain and insulin resistance (fasting plasma insulin, HOMA, ELISA) was studied in Hungarian psychiatryic patients (n=60) treated with SGA (clozapine, olanzapine, risperidone, quetiapine, 15 each). After 1 year, 80% of patients became overweight/obese (BMI > 27/30) and 35% (n= 21/60) presented impaired glucose tolerance (13/60) or diabetes (8/60). Ghrelin (1.3 +/- 0.6 ng/ml), resistin (9.8 +/- 3.7 ng/ml), TNF-alpha (5.8 +/- 1.7 pg/ml), insulin (10.4 +/- 7.6 U/ml, HOMA A: 2.5 +/- 1.8, HOMA B: 133 +/- 62.5) were significantly higher in patients than in healthy matched controls. Resistin and TNF-alpha positively correlated with each other, insulin, HOMA, and negatively with ghrelin. Ghrelin contributes to weight gain, resistin and TNF-alpha to insulin resistance. A negative feedback regulation may exist between adipocytokines and ghrelin production. SGA drugs enhance ghrelin production despite the suppressive effect of adipocytokines. All four SGA drugs are equally obesitogenic and diabetogenic.

Antipsychotic Agents↗
PubMed2003

Retrospective detection of a subclinical hepatitis A virus (HAV) epidemic affecting juvenile cohorts of the Hungarian population.

Sero-epidemiological surveys of serum samples taken in 1982, 1987, 1994 and 1999 have been performed with hepatitis A virus-specific (HAV-specific) serological tests. Results obtained during these surveys show that the proportion of seropositive blood donors decreased from 69% to 18% within 17 years. The authors have recognised a (mainly subclinical) epidemic, affecting about 115000 teenagers in 1992-1994 in Hungary, is a threatening phenomenon. It was calculated that only about 3600 clinical diseases were associated with the epidemic, recognised retrospectively from the findings of the four sero-epidemiological surveys. Epidemiological data indicated that the excess clinical diseases caused by HAV concentrated in the southern counties of Hungary, which have been affected by the social and military activities between 1992 and 1994. Due to the decrease of subjects seropositive for HAV, sera from preselected or actively immunised donors will be required in the future and vaccination against HAV with killed virus is likely to be recommended for risk groups. Furthermore, health authorities might promote active immunisation of young children against HAV infection; for that, promotion of manufacturing combination vaccines of HAV/HBV/DPT or, for certain countries, HAV/DPT would be desirable.

Adolescent↗
PubMed2003

[New data for the public health importance of hantaviruses in Hungary].

INTRODUCTION: The authors present recent results in the Hungarian hantavirus ecology and epidemiology. Most of the research was done between 1992-2000. AIM: To determine the presence and geographic distribution of hantaviruses and to get more detailed information of human and small-mammal infection with these viruses in Hungary. METHODS: For diagnostic purposes (patients' sera), serosurvey of healthy persons and serological investigations of small mammals, the following tests were used: indirect fluorescent antibody, high density particle agglutination and enzyme-linked immunosorbent assay (ELISA). Virus isolation, antigen-, and nucleic acid detection were conducted for ecological investigations. RESULTS: 235 of 831 patients proved to be seropositive. 2257 sera of age matched Hungarian citizens above 20 years were tested in 2000. The average seropositivity proved to be about 10% using two different methods. Sera of 1512 individuals of nearly 20 different mammalian species were tested. Serological results revealed the prevalence of antibodies to human pathogen hantaviruses among rodents of about 7.25 percent. Molecular analysis of viral nucleic acid isolates from organs of four rodents proved directly the presence of viruses belonging to Puumala and Dobrava/Belgrade species in Hungary. Sequences corresponding to the Dobrava/Belgrade type viruses were found in two different rodent species. This suggests the existence of two hosts with different living preferences. CONCLUSIONS: At least two different human pathogen hantaviruses are circulating in Hungary. It has to be considered, that viruses belonging to the Dobrava/Belgrade species could emerge not only in the forested areas, but in the agricultural areas as well. Commercially available kits are not perfectly suitable for the detection of antibodies rised to domestic hantaviruses. It is necessary to built an appropriate laboratory for the hantavirus research in Hungary.

Adolescent↗