Latest news with #antipsychotics
Medscape
a day ago
- Health
- Medscape
Antipsychotic Adherence Linked With Lower Car Crash Risk
In drivers with schizophrenia, better adherence to antipsychotic medication is associated with a lower risk for motor vehicle crashes, according to new research. In a case-crossover study, perfect adherence to antipsychotic medication in drivers with schizophrenia was associated with a 50% reduction in the odds of a crash, relative to complete nonadherence. Physicians and fitness-to-drive policy makers might consider antipsychotic treatment adherence as a condition for maintaining an active driver's license in these patients, the authors suggest. The study was published June 9 in the Canadian Medical Association Journal. Driving Safety Data 'Whether a person is safe to drive is a question that comes up for psychiatrists and physicians like me who look after people when they are in the hospital with a worsening of their schizophrenia,' study author John A. Staples, MD, MPH, clinical associate professor of medicine at the University of British Columbia in Vancouver, told Medscape Medical News . John A. Staples, MD, MPH 'This is particularly important for people who have schizophrenia, because we know schizophrenia impairs their judgment. Often, these individuals have had problems with driving in the past,' Staples said. The investigators examined population-based administrative health and driving data from British Columbia. They included patients with schizophrenia who were involved as drivers in police-attended motor vehicle crashes from 2001 to 2016. Eligible participants filled prescriptions for antipsychotic medication as outpatients in the 2 years before the crash. 'We have data on all their health issues specific to hospital visits with physicians and medication data, and we also have data on their driving, including crashes and traffic accidents. It's unique that we have both data sets,' Staples noted. The investigators assessed adherence by looking at how often in the 30 days before their crash these drivers filled prescriptions for their antipsychotic medication. They also examined how often patients filled the prescriptions in a 30-day period 1 year before the crash. The final sample consisted of 1130 crashes involving 1001 drivers. At the time of the crash, the median age of the drivers was 37 years. Two-thirds of participants were male, 58.1% resided in an urban area, and 84.5% had a driver's license. More than half (54.8%) also had one or more traffic violations in the past 3 years. About half (49.8%) of all crashes resulted in an injury, and 0.7% resulted in a fatality. Attending police reported that the driver's condition was a contributing factor in 43.5% of the crashes. 'We hope these findings encourage people with schizophrenia to take their antipsychotics,' Staples said. The results should also highlight the need for physicians faced with patients who may not be adherent to think about driving safety. 'We don't want there to be a crash where somebody gets hurt, but on the other hand, suspending or canceling somebody's license is a grave blow to independence and the ability to work. That's the difficult tradeoff physicians are often left struggling with. We want to make sure we are making decisions that are justified when we take away the freedom of being able to drive,' Staples said. Valuable Research Mark Rapoport, MD, professor of psychiatry at the University of Toronto, told Medscape Medical News that physicians treating patients with schizophrenia should stress the importance of adherence and driving safety. 'This is a very good study that shows the positive outcome of staying on medication. But there is variability among individuals, so it is hard to make a sweeping declaration that everyone must be adherent or they can't drive. To me as a clinician, it comes down to the judgment and insight of the patient. Do they have the wherewithal to realize that they should wait until they take their medication before they get behind the wheel? That they need to take another form of transportation? Some people don't have the ability to do that,' Rapoport said. 'A study like this can't answer those nuanced questions, but it is a good study that shows the very positive outcome of staying on medication,' he said. Simon B. Sherry, PhD 'Given the elevated crash risk among those with schizophrenia, this research is valuable in that it provides evidence of the efficacy of antipsychotics in improving a person's safety and well-being as it applies to driving,' Simon B. Sherry, PhD, professor of psychology and neuroscience at Dalhousie University in Halifax, told Medscape Medical News. 'The ability to drive can provide freedom and independence and improve quality of life. Unfortunately, many of the symptoms of schizophrenia, such as disorganized thinking; reduced motivation; trouble with attention, memory, and decision-making; and difficulty with daily activities, can make regularly taking medication more challenging,' Sherry said. 'As a psychologist, I do not prescribe medication, but I can vouch for the efficacy of nonpharmaceutical treatments such as cognitive behavioral therapy for managing symptoms. It would be interesting to see future research comparing whether this therapy is also associated with lower crash risk and whether such treatment is equally effective in reducing crash risk as antipsychotic medications,' he said.
ABC News
3 days ago
- Health
- ABC News
Could Ozempic help with schizophrenia?
Australians living with schizophrenia die about twenty years earlier than the general population, and that's not driven by suicide but cardio metabolic disease. Anti-psychotics can add to an already increased risk of weight gain, which specialists say causes some patients to avoid their medication altogether. But a new study from the University of Queensland, published in the world leading Lancet medical journal, shows semaglutide or ozempic could help patients with schizophrenia stay medicated and out of hospital for longer.
ABC News
4 days ago
- Health
- ABC News
Calls for weight-loss drugs like Ozempic to be subsidised for people with schizophrenia
Queensland researchers are calling for weight-loss medicines to be listed on the Pharmaceutical Benefits Scheme (PBS) for people with schizophrenia, after a trial found they didn't affect psychotic symptoms. The team at University of Queensland said weight gain was a major side effect of common antipsychotic drugs, leading to an "epidemic" of obesity-related concerns for people with schizophrenia. Professor of psychiatry and doctor at Metro South Health Service Dan Siskind said one of the most common complaints he had from patients was their "frustration" with gaining weight from their antipsychotic medications. He said people with schizophrenia also faced physical health complications due to weight gain and obesity. "We know about the common symptoms of schizophrenia like voices, paranoia [and] confused thinking," he explained. "One thing that's not often talked about is that people with schizophrenia live about 20 years shorter than the general population, and that's not due to suicide. According to the Mental Illness Fellowship of Australia, about 200,000 people are affected by schizophrenia nationwide. Dr Siskind said there was a shared genetic link between sugar metabolism defects and schizophrenia, meaning poor diet and lack of exercise could be contributing factors, but said prescribed antipsychotic medications like clozapine could also be causing weight gain. He said he's seen a small proportion of his patients stop their medications, while others have continued to deal with ongoing issues and considered stopping them. "When people stop their medication, they get really unwell, they get re-hospitalised … and the weight gain causes a lot of stigma," he said. As part of his work, Dr Siskind helped patients who experienced severe mental illnesses improve their diet and exercise, but said pharmacological interventions were also essential. Community nutritionist Donni Johnston, who also worked with people with severe mental illnesses, agreed. She said a range of factors influenced weight gain, including medications that might see people experiencing uncontrollable hunger and an insatiable appetite. Ms Johnson explained socio-economic factors like a lack of education, or those living in residential care not having learned to cook, could also have an impact. "I do a lot around encouraging people to make healthy choices, but it can be almost unfair on people when they're on medications that are causing such an increased appetite," she said. But Ms Johnston stressed the importance of continuing to strive for a healthy diet, alongside medications. "We know that having a healthy diet impacts our feelings of anxiety and depression and some of those symptoms of mental illness, but [it's] also really important in preventing chronic disease," she said. A recent study led by Dr Siskind focused on semaglutide, the active component in weight-loss drugs sold under the brand names Ozempic or Wegovy. Previously, people with schizophrenia had been excluded from clinical trials of Ozempic, he said, which meant it wasn't clear if the weight loss drug would interfere with other medications. The 36-week investigator-led trial, involving 31 participants with schizophrenia, found those on Ozempic lost 13.5 per cent more of their body weight than those taking a placebo. Many of the participants started off the study around the 100 kilogram mark. "People were telling me about how comfortable and proud they felt," Dr Siskind said. "I had one [person] who took up ice hockey after he lost all of the weight because he could get back on his skates." He said the important finding from the study was that the weight-loss medications didn't increase psychosis, or impact the effect of antipsychotic medications as measured by blood levels. No pharmaceutical companies were involved in the study. In Australia, Ozempic is not listed on the Pharmaceutical Benefits Scheme (PBS) for weight loss for people with schizophrenia, which is something researchers are calling for. Dr Siskind said many of his patients lived on the pension and didn't have the kind of disposable income necessary to afford the "quite expensive" medication otherwise. A month's supply of Ozempic with a private prescription generally costs between $130 to $200 in Australia. A spokesperson for the federal health department said weight gain as a side effect of medication was best managed by a patient's prescriber. "Decisions to list new medicines on the PBS rely on pharmaceutical companies making applications to the Pharmaceutical Benefits Advisory Committee (PBAC)," the spokesperson said. "The government cannot make a new PBS listing unless it has been recommended by the PBAC." No medications are currently listed on the PBS with "weight management" as their intended use. In a statement, Australian Medical Association Queensland president Dr Nick Yim said he welcomed any reviews and updates to the PBS, but said supplies of semaglutide continued to be a concern. "We know [it] continues to be in short supply and improving access to it is an ongoing challenge," he said. The research will be published today in Lancet Psychiatry.
