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Biomedical subjects

Martina Hummer

Publications and source records attributed to Martina Hummer.

24 records · Page 2Linked to original sources
PubMed2003

The safety of clozapine in the treatment of first- and multiple-episode patients with treatment-resistant schizophrenia.

The importance of antipsychotics in the treatment of schizophrenia has been documented in numerous clinical trials. In addition to its established superiority over other antipsychotics in treatment-resistant patients, clozapine has been consistently shown to improve psychopathology and other psychosocial outcome variables in patients with schizophrenia. To determine whether the course of the illness has an influence on response and side-effects to clozapine, we directly contrasted first- and multiple-episode patients with schizophrenia, who had histories of failing response to traditional antipsychotics, during the acute treatment phase. Thirty-nine first-episode patients with schizophrenia and 56 patients who had suffered from at least two episodes of this illness were investigated. Severity of illness and clinical improvement were rated by means of the CGI Scale. Vital signs were recorded weekly. Side-effects were regularly assessed with the UKU Side Effect Rating Scale. Compliance was regularly assessed by clinical interviews and plasma level monitoring. By using comparable mean clozapine doses, the number of treatment responders was similar in both groups (first-episode patients, 51.3%; multiple-episode patients, 46.4%). However, we found a negative association between age and response rate. With regard to side-effects, we could not find any significant difference between groups. Altogether, response and side-effects to clozapine treatment do not seem to be determined by the chronicity of the disorder.

Adult↗
PubMed2003

Attitudes of patients with schizophrenia toward placebo-controlled clinical trials.

BACKGROUND: Despite the fact that the efficacy of antipsychotic treatment in patients with schizophrenia has been demonstrated in numerous double-blind studies, placebo-controlled studies are still commonly performed. Although much is known about the opinions of professionals concerning this issue, so far nothing is known about the opinions of patients who are most affected by the realization of placebo-controlled clinical trials. METHOD: In a cross-sectional study from June 2000 to January 2001, 100 inpatients and outpatients with ICD-10 schizophrenia or schizophreniform disorder were investigated by using a questionnaire specifically developed to survey patients' attitudes concerning possible participation in placebo-controlled clinical trials. Psychopathology and side effects were physician-rated. RESULTS: 56% of patients would not be willing to participate in a placebo-controlled clinical trial. On the other hand, only about 16% of the patients are against clinical trials in principle. Gender, treatment, severity of psychopathology (Positive and Negative Syndrome Scale), adverse events (UKU Side Effect Rating Scale), and attitude toward medication (Drug Attitude Inventory) had no statistically significant influence on the decision. Most of the patients (76%) stated that they would not lose trust in their physician if asked to participate in a placebo-controlled clinical trial. CONCLUSION: The opinions and fears of patients who are most affected by the debate need to be considered when deciding whether a placebo-controlled clinical trial is necessary.

Adult↗
PubMed2003

Olanzapine induces insulin resistance: results from a prospective study.

BACKGROUND: The aim of this study was to compare glucose metabolism in patients with schizophrenia receiving olanzapine with that in control subjects. METHOD: We conducted a prospective, controlled, open study comparing body weight, fat mass, and indices of insulin resistance/ sensitivity in 10 olanzapine-treated patients with ICD-10 schizophrenia (olanzapine dose range, 7.5-20 mg/day) with those of a group of 10 mentally and physically healthy volunteers. Weight, fat mass, and indices of insulin resistance/sensitivity were assessed over individual 8-week observation periods from November 1997 to October 1999. RESULTS: Fasting serum glucose and fasting serum insulin increased significantly in the olanzapine-treated patients (p =.008 for glucose and p =.006 for insulin). The homeostasis model assessment (HOMA) index for beta cell function did not change significantly in the olanzapine-treated patients, whereas the HOMA index for insulin resistance did increase (p =.006). In the control group, these parameters were stable. A significant increase in body weight (p =.001) and body fat (p =.004) was seen in patients treated with olanzapine, while the control group showed no significant changes. CONCLUSION: This study indicates that the disturbances in glucose homeostasis during antipsychotic treatment with olanzapine are mainly due to insulin resistance. However, beta cell function remains unaltered in olanzapine-treated patients. We conclude that treatment with some second-generation antipsychotic drugs may lead to insulin resistance.

Adult↗
PubMed2003

Factors influencing compliance in schizophrenia patients.

Scientifically, compliance can be expressed as the ratio between an observed treatment behavior and given treatment standards. Although the factors that influence compliance often overlap or influence each other, it is possible to differentiate between factors that are related to the patient, the patient's environment, the treating clinician, and treatment itself. Although this differentiation is in some ways artificial, it may aid the practicing clinician in assessing the various reasons why a particular patient is likely to develop or has already developed compliance problems. The fact that a number of circumstances and parties are involved in the multifaceted issue of compliance makes it evident that patients must never be solely blamed for compliance problems. Despite the fact that compliance behavior is difficult to study from a methodological point of view, the scientific information available to date does provide many important leads for the engaged clinician to prevent and manage compliance problems.

Antipsychotic Agents↗
PubMed2002

Attitudes toward antipsychotics among outpatient clinic attendees with schizophrenia.

BACKGROUND: A cross-sectional study was conducted in patients with schizophrenia who regularly attended an outpatient clinic to examine the impact of psychopathology, side effects, and sociodemographic factors on attitudes toward antipsychotics. METHOD: Sixty patients with a schizophrenic disorder according to ICD-10 criteria who had a duration of illness over 1 year and whose discharge from an inpatient unit had been at least 6 weeks earlier were investigated. Apart from the registration of demographic data, various rating scales were used: the Positive and Negative Syndrome Scale, the St. Hans Rating Scale for Extrapyramidal Syndromes, the Udvalg for Kliniske Undersogelser (UKU) Side Effect Rating Scale, and the Drug Attitude Inventory (DAI). RESULTS: Generally, the aspects describing a positive attitude toward antipsychotics on the DAI received a higher degree of assent than those characterizing a negative drug attitude. However, employment status correlated with a poorer global medication attitude on the DAI, and positive symptoms and sedation correlated with greater negative feelings on the DAI subjective negative feelings subscale. CONCLUSION: Our results suggest that special attention should be paid to patients who experience positive symptoms or sedation and to those with relative absence of symptoms, who are therefore tempted to stop taking medication.

Adult↗