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Mong-Liang Lu

Publications and source records attributed to Mong-Liang Lu.

18 recordsLinked to original sources
PubMed2006

The early effect of olanzapine and risperidone on insulin secretion in atypical-naïve schizophrenic patients.

Recently, increasing attention has been drawn to the potential diabetogenic effect of atypical antipsychotics. The goal of this prospective study is to evaluate the early effect of olanzapine and risperidone treatment on pancreatic beta-cell function in atypical-naive schizophrenic patients. Twenty-six subjects were assigned randomly to therapy with olanzapine or risperidone for 14 days. The metabolic parameters were quantitatively assessed by using the intravenous glucose tolerance test. The levels of fasting glucose, fasting insulin, lipid profiles, and leptin were also assessed. There were no significant within-group changes in weight or body mass index for both groups after 2 weeks of treatment. The levels of fasting glucose, fasting insulin, cholesterol, or leptin did not change in both groups. The triglyceride level significantly increased in olanzapine group. Glucose disappearance rate and insulin sensitivity did not change in both groups. Insulin secretion significantly decreased in olanzapine group. After 2 weeks of olanzapine treatment, schizophrenic patients decreased insulin secretory response to a hyperglycemic challenge. The results of this study support the hypothesis that olanzapine might directly impair pancreatic beta-cell function.

Adolescent↗
PubMed2005

The use of alternative medicine among Taiwanese psychiatric outpatients.

The present study is intended to examine the use of alternative therapy and their help-behavior among patients who first visited psychiatric clinic in Taiwan. We recruited 150 patients from three general hospital psychiatric clinics. We collected the information of their demographic data, help-seeking behavior, and the use of alternative therapy, then screened them using Beck's Depression Inventory, Beck Anxiety Inventory, and World Health Organization's Quality of Life assessment. We found that 53 (35.3%) of 150 psychiatric outpatients visited an alternative therapists or received some type of alternative therapy at least once. Alternative medicine users were more likely to be married (P=0.004), to suffer from more intensive anxiety symptoms (P=0.018), to have visited more psychiatrists (P=0.006), to have visited more clinics (P=0.001), and to have taken longer between onset of the symptoms and their first visit to the psychiatric clinic (P=0.028). Based on these findings we suggest that alternative therapy plays important roles in the help-seeking behavior of Taiwanese psychiatric patients, and that alternative medicine users tend to delay proper psychiatric care. Clinicians should inquire about patients' past history of seeking alternative therapy, build a firm trust in the doctor-patient relationship, and increase the compliance of psychiatric treatment in alternative therapy users.

Adult↗
PubMed2004

Posttraumatic stress disorder among professional and non-professional rescuers involved in an earthquake in Taiwan.

This study investigated the prevalence of posttraumatic stress disorder (PTSD) among professional and non-professional rescue workers involved in the 1999 Chi-Chi Earthquake in Taiwan. One month following the disaster, 252 rescue workers (167 professional rescue workers, 85 non-professional volunteers) were surveyed with the Chinese version of the Davidson Trauma Scale (DTS-C) and the Chinese version of the SPAN (SPAN-C). Non-professional rescuers had significantly higher scores than professional rescuers on both the DTS-C and the SPAN-C. The prevalences of PTSD, as defined by a DTS-C score > or = 44, among professional and non-professional rescuers were 19.8% and 31.8%, respectively. Among the three subscales of the DTS-C, only scores on the numbness/avoidance subscale were significantly higher in the non-professional than in the professional rescue workers. The results of this study suggest that disaster rescue work is associated with a high level of stress even for highly trained professionals and may lead to mental health problems.

Adult↗
PubMed2004

Heavy smoking, reduced olanzapine levels, and treatment effects: a case report.

A 30-year-old schizophrenic male patient, a heavy smoker, was successfully treated with olanzapine 15 mg/d during hospitalization. His cigarette consumption increased rapidly from 12 to 80 cigarettes per day following his discharge. Ten days later, his delusion of persecution, levels of hostility, and aggressive behavior worsened, while the plasma levels of olanzapine concurrently decreased. Based on our observations of this case, we suggest that the reduced levels of plasma olanzapine and exacerbated clinical symptoms are closely related to the increased consumption of cigarettes. A possible explanation would be that heavy smoking induced cytochrome P4501A2, the major enzyme involved in olanzapine metabolism. Therefore, patients who smoke should be closely monitored for their cigarette consumption when the dosage of olanzapine is adjusted.

Adult↗
PubMed2004

Implication of serum concentration monitoring in patients with lithium intoxication.

The aim of the present study was to determine the relationships between serum lithium level, duration of lithium intoxication, severity of symptoms, and the outcome of the disease. Subjects with a serum lithium level of >/=1.2 mEq/L were included in the study. Seventy-eight patients with lithium intoxication were identified between 1 July 1999 and 31 December 2002. The demographic characteristics, clinical manifestations, and concomitant medications were recorded. Most patients with acute lithium intoxication had mild symptoms, independent of the serum lithium levels. In patients with chronic lithium intoxication, the frequency of severe symptoms was higher than in those with acute intoxication. None of the 78 intoxicated patients in the present survey died or suffered from persistent neurological sequelae. Patients with concomitant medications, older age, and existing neurological illness may have an increased susceptibility to lithium toxicity. Regular monitoring of serum lithium level is essential for lithium-treated patients. Clinicians should pay attention to patients with pre-existing neurological illness, older age, or receiving medications that may interact with lithium.

Acute Disease↗
PubMed2004

Dose-dependent alternations in the pharmacokinetics of olanzapine during coadministration of fluvoxamine in patients with schizophrenia.

Olanzapine, an atypical antipsychotic agent, is a substrate of the cytochrome P4501A2 (CYP1A2) enzyme. Administration of a potent CYP1A2 inhibitor (eg, fluvoxamine) may alter the pharmacokinetics of olanzapine. This study investigated the pharmacokinetic interactions between olanzapine and fluvoxamine in patients with schizophrenia. Ten male smokers were administrated a single dose of olanzapine 10 mg at baseline, followed by 2 weeks of fluvoxamine 50 mg/day and another 2 weeks of fluvoxamine 100 mg/day. Olanzapine 10 mg was given at day 10 during each fluvoxamine treatment. After pretreatment with fluvoxamine, the area under the curve, maximal plasma concentration, and half-time of olanzapine were significantly increased by 30% to 55%, 12% to 64%, and 25% to 32%, respectively. Volume of distribution and apparent clearance were significantly reduced by 4% to 26% and 26% t O 38%, respectively, after administration of fluvoxamine. Increases in area under the plasma concentration-time curve from time 0 to infinity appear to be dose dependent. Presumably, altered olanzapine pharmacokinetics are attributed to the inhibition of CYP1A2. Patients treated with the combination of olanzapine and fluvoxamine should be monitored carefully.

Adult↗
PubMed2004

Adjunctive fluvoxamine inhibits clozapine-related weight gain and metabolic disturbances.

BACKGROUND: Adjunctive fluvoxamine inhibits clozapine metabolism and decreases plasma norclozapine (a toxic metabolite of clozapine) to clozapine ratios. This study aimed to demonstrate the effects of fluvoxamine on clozapine-related weight gain, hyperglycemia, and lipid abnormalities. METHOD: Sixty-eight treatment-resistant inpatients with a DSM-IV diagnosis of schizophrenia were randomly assigned to 2 treatment groups for 12 weeks. The monotherapy group (N = 34) received clozapine (< or = 600 mg/day). The coadministration group (N = 34) received fluvoxamine (50 mg/day) plus low-dose clozapine (< or = 250 mg/day). The study was conducted from August 1999 to October 2002. RESULTS: The 2 groups were similar in demographic data; baseline body weight and body mass index (BMI); baseline serum glucose, triglyceride, and cholesterol levels; and steady-state plasma clozapine concentration. The monotherapy patients (but not the coadministration patients) had significantly higher (p < .05) body weight, BMI, and serum glucose and triglyceride levels after treatment than at baseline. At week 12, the monotherapy patients also had significantly higher glucose (p = .035), triglyceride (p = .041), and norclozapine (p = .009) (and numerically higher cholesterol) levels than the cotreatment patients. The changes in weight and serum glucose and triglyceride levels were significantly correlated (p = .026, p = .005, and p = .028, respectively) with the plasma concentration of norclozapine but not with plasma levels of clozapine. CONCLUSION: These results suggest that fluvoxamine cotreatment can attenuate weight gain and metabolic disturbances in clozapine-treated patients. Plasma levels of norclozapine, but not clozapine, are associated with increases in weight and serum glucose and triglyceride levels. Of note, coadministration of fluvoxamine could increase plasma clozapine levels markedly and carry the risk of adverse events. If this combined treatment is applied, conservative introduction with reduced clozapine dosage and careful therapeutic drug monitoring of clozapine concentration is recommended.

Adolescent↗
PubMed2003

Polyunsaturated fatty acid deficit in patients with bipolar mania.

The aim of this study is to test the hypothesis that there is a depletion of polyunsaturated fatty acids of erythrocyte membranes in patients with bipolar disorder and to connect the previous therapeutic and psychoimmunological findings. Fatty acid compositions of erythrocyte membranes in 20 bipolar manic patients and 20 healthy controls were analyzed by thin-layer chromatography and gas chromatography. The major finding was significantly reduced arachidonic acid (20:4n-6) and docosahexaenoic acid (22:6n-3) compositions in bipolar patients as compared to normal controls with P values of 0.000 and 0.002, respectively. There were no differences in total omega-3 and omega-6 polyunsaturated fatty acids. This abnormality may be related to the mechanisms of action of mood stabilizers and the previous findings on the abnormal psychoimmunology of patients with bipolar disorder. Larger sample sizes of medicated patients or drug-free manic, well-controlled designs on the diet and smoking, and fatty acid composition measurements during full remission after the index episode are warranted in future studies.

Adult↗
PubMed2002

Metoclopramide-induced supersensitivity psychosis.

OBJECTIVE: To report 2 cases of metoclopramide-induced supersensitivity psychosis. CASE SUMMARIES: A 74-year-old Taiwanese man was treated with metoclopramide 5 mg 4 times daily for 6 months. A second patient, a 65-year-old Taiwanese man, was treated with metoclopramide 5 mg 4 times daily for 3 months. After discontinuation of metoclopramide, both patients developed hallucinatory experiences and delusions. DISCUSSION: This is the first report of metoclopramide-induced supersensitivity psychosis. Chronic administration of a dopamine antagonist (e.g., metoclopramide) might induce dopamine receptor supersensitivity. It is hypothesized that exacerbation or occurrence of psychotic symptoms following neuroleptic withdrawal results from mesolimbic dopamine supersensitivity. CONCLUSIONS: The complications of long-term metoclopramide therapy should be seriously considered when the treatment regimens are being planned. Clinicians should attempt to treat patients with the lowest effective dosage of medication for the briefest therapeutic period to minimize the risks of adverse reactions.

Aged↗
PubMedDate not supplied

Screening postpartum depression with the Taiwanese version of the Edinburgh Postnatal Depression scale.

This study is intended to develop the Taiwanese version of the Edinburgh Postnatal Depression Scale (EPDS-T), to evaluate its validity, and to estimate the prevalence of postpartum depressive disorders (PPD) among Taiwanese women. A prospective cohort of 203 subjects who completed the EPDS-T, the Beck Depression Inventory (BDI-II), and postpartum questionnaire at 6 weeks after giving birth were assessed with the Mini-International Neuropsychiatric Interview (MINI) and DSM-IV to establish their psychiatric diagnoses. We tested the validity of EPDS-T against the clinical diagnoses and compared its applicability with BDI-II. We found that the Taiwanese version of EPDS-T had satisfactory sensitivity and better specificity than BDI-II, that the 12/13 cutoff point was the best for screening PPD, and that 10.3% of the study population suffered from depressive disorders at 6 weeks postpartum. Based on the findings of this study, we suggest that PPD prevalence among Taiwanese women is not lower than that among most Western populations and that the validated EPDS-T can be used for early detection and management of postpartum depression in Taiwan.

Adult↗
PubMedDate not supplied

The validation study and application of stratum-specific likelihood ratios in the Chinese version of SPAN.

The Davidson Trauma Scale (DTS) is a validated self-rating scale used in the diagnosis of post-traumatic stress disorder (PTSD). A shorter version of the DTS was developed to serve as a diagnostic screening tool. A four-item scale, the SPAN (named for its principal four items: Startle, Physiological arousal, Anger, and Numbness), was then developed. This report investigates the psychometric validation of the Chinese version of the SPAN (SPAN-C). Subjects were drawn from a sample of 210 survivors of the September 21, 1999 Chi-Chi Earthquake. The scale showed good internal consistency (Cronbach's alpha= 0.77) and test-retest reliability (r = 0.90). Concurrent validity was obtained against the clinical diagnostic interview, with a diagnostic accuracy of 0.8 at a SPAN-C score of 5. The recommended stratum-specific likelihood ratios were 0.04 (95% confidence interval [CI], 0.02 to 0.07) for the score range of 0 to 2, 0.93 (95% CI, 0.51 to 1.71) for the score range of 3 to 4, 2.31 (95% CI, 1.17 to 4.57) for the score range of 5 to 6, and 5.23 (95% CI, 3.12 to 8.78) for scores above 7. The psychometric strength of the SPAN-C indicates its reliability for future use, particularly for screening for subjects with a possible diagnosis of PTSD.

Adolescent↗