1.
A randomized placebo-controlled trial of an omega-3 fatty acid and vitamins E+C in schizophrenia.
Bentsen, H, Osnes, K, Refsum, H, Solberg, DK, Bøhmer, T
Translational psychiatry. 2013;(12):e335
Abstract
Membrane lipid metabolism and redox regulation may be disturbed in schizophrenia. We examined the clinical effect of adding an omega-3 fatty acid and/or vitamins E+C to antipsychotics. It was hypothesized that lower baseline levels of polyunsaturated fatty acids (PUFAs) would predict more benefit from the add-on treatment. The trial had a multicenter, randomized, double-blind, placebo-controlled 2 × 2 factorial design. Patients aged 18-39 years with schizophrenia or related psychoses were consecutively included at admission to psychiatric departments in Norway. They received active or placebo ethyl-eicosapentaenoate (EPA) 2 g day⁻¹ and active or placebo vitamin E 364 mg day⁻¹+vitamin C 1000 mg day⁻¹ (vitamins) for 16 weeks. The main outcome measures were Positive and Negative Syndrome Scale (PANSS) total and subscales scores, analyzed by linear mixed models. Ninety-nine patients were included. At baseline, erythrocyte PUFA were measured in 97 subjects. Given separately, EPA and vitamins increased drop-out rates, whereas when combined they did not differ from placebo. In low PUFA patients, EPA alone impaired the course of total PANSS (Cohen's d=0.29; P=0.03) and psychotic symptoms (d=0.40; P=0.003), especially persecutory delusions (d=0.48; P=0.0004). Vitamins alone impaired the course of psychotic symptoms (d= 0.37; P=0.005), especially persecutory delusions (d=0.47; P=0.0005). Adding vitamins to EPA neutralized the detrimental effect on psychosis (interaction d=0.31; P=0.02). In high PUFA patients, there were no significant effects of trial drugs on PANSS scales. In conclusion, given separately during an acute episode, EPA and vitamins E+C induce psychotic symptoms in patients with low levels of PUFA. Combined, these agents seem safe.
2.
[Basic and metabolic therapy of hypertensive disease in pregnant women].
Leshchinskiĭ, LA, Gaĭsin, IR, Maksimov, NI
Klinicheskaia meditsina. 2008;(9):25-8
Abstract
This open non-randomized study had the objective to analyse the course of pregnancy and labor as well as their outcomes in 62 women with hypertensive disease (essential hypertention). The patients were allocated to two groups, one (group 1) comprising 32 the other (group 2, control) 30 women. All patients in group 1 underwent pregravid preparation and remained under observation throughout the pregnancy period in specialized cardiological departments. They were given treatment that included intake of antihypertensive drugs (methyldopa, long-acting nifedipin, metoprolol), desaggregant (dipyridamole, pentoxifllin), and metabolically active agent (vitamin E, folic acid, magnesium orotate, actovegin, cocarboxylase, and inosin). Gestosis developed in 25% of the patients in group 1 within 37 weeks and in 56.7% of the women (p < 0.05) in group 2 within 23-37 weeks of pregnancy. Circulatory disturbances in the mother-placenta-fetus system were recorded in 25% and 50% of the women in groups 1 and 2 respectively (p < 0.05), intrauterine fetal hypoxia in 18.8 and 50% (p < 0.05), chronic fetoplacental insufficiency in and fetal growth retardation syndrome in 12.5 and 40% (p < 0.05). In group 2, the perinatal mortality rate was 66.7% and perinatal losses amounted to 100.0% compared with their absence in group 1 (p < 0.05). Premature delivery occurred in 30% of the women in group 2 and was absent in group 1 (p < 0.05). In group 1, 9.4 of the newborn infants had low birth weight compared with 33.3% of the live full-term infants in group 2 (p < 0.05). Conjugated jaundice prevailed among the diseases affecting newborns in group 1 whereas intrauterine infections and posthypoxic encephalopathies were most common in group 2 It is concluded than combined therapy of hypertensive disease in women delayed the development of gestosis and made it possible to maintain pregnancy till normal outcome for both the mother and the child.