Pharmacotherapy of Schizophrenia: Ploypharmacy Approaches

"nSchizophrenia is a debilitating illness, rating as one of the leading causes of lost years of quality of life. The illness imposes a disproportionate burden on patients and their families, healthcare systems and society. Pharmacological management is the cornerstone of treatment of schizophrenia, and antipsychotics, both first generation of antipsychotics and second generation of antipsychotics, are efficacious in reducing levels of psychopathology in acute episodes of schizophrenia. Clearly a need for innovative treatment strategies in schizophrenia that will ensure increased effectiveness against negative symptoms and cognitive dysfunction dysfunction. Therefore, in majority of cases polypharmacy is one of the effective approaches. This review focused on polypharmacy in the treatment of schizophrenia and in particular negative symptoms

Phylogenetic comparison of the A genome using karyotype analysis in some Triticum species

The Karyotype analysis was performed on 46 wheat accessions belonging to five species (Triticum monococcum, T. urartu, T. durum, T. turgidum and T. aestivum) and two subspecies (T. boeoticum subsp. thaodar and T. boeoticum subsp. boeoticum) carrying A genome. All chromosomal sizes were measured with computer-aided program Micro Measure 3.3. Software. RL, TCL, MCL, arm ratio, centromeric index, TF%, mean of long and short arms, AsI%, S%, DRL, A1, A2 and karyotype formula were calculated for each chromosome. All the accessions were placed in 1A category of stebbines asymmetry categories. The scatter diagram based on A1 and A2 constructed three groups of karyotype asymmetry in the accessions studied: 1- T. aestivum with the highest asymmetrical karyotype, 2- T. monococcum, T. boeoticum subsp. thaodar and T. boeoticum subsp. boeoticum with the lowest asymmetrical karyotype and 3- T. urartu, T. turgidum and T. durum being with an intermediate between the two previous groups. T. monococcum based on the A1 and A2 index (asymmetric index) had the oldest and the most primitive karyotype among diploid species. According to the results, it might be suggested that T. durum is more primitive than T. turgidum and T. monococcum could be considered as a donor of A genome to T. durum and T. aestivum

Prevalence of psychosis and its relationship with substance use disorder in patients with bipolar disorder in Iran

Background: The correlation between psychosis and bipolar disorder is a crucial and complex matter that requires attention and study. In this study, researchers examined the relationship between the current episode status, substance use disorder, different types of substance use, and psychotic symptoms in inpatients with bipolar disorder. Methods: The study included 150 patients who were diagnosed with bipolar disorder based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). These patients were referred to the emergency department of Roozbeh Psychiatric Hospital in Iran between November 2019 and February 2020. The Structured Clinical Interview for the DSM-5 (SCID-5) questionnaire was used to diagnose the patient's bipolar disorder, including episodes of depression and mania, as well as their substance use disorder. The type of substance used and the pattern of its use were also evaluated using this questionnaire. Additionally, a faculty member of the psychiatry department at Tehran University of Medical Sciences carefully evaluated the patient's condition for the presence of psychotic symptoms using a psychiatric diagnostic interview. Results: Out of 150 inpatients diagnosed with bipolar disorder, 89 (59.3 %) had comorbid substance use disorder. Among these 89 patients, 42 (47.2 %) had psychotic symptoms, whereas 79 (52.7 %) of the total 150 inpatients had psychotic symptoms. There was no significant relationship between substance use disorder (p-value=0.86), the type of substance used in a recent episode (p-value=0.93), and the current episode type (p-value=0.69) with psychotic symptoms. Limitations: The study's generalizability is limited to hospital patients with bipolar disorder. Additionally, since it was a cross-sectional study, causal interpretation was not possible. Conclusions: The study suggests a primary link between bipolar disorder and psychosis, independent of substance use. Longitudinal multicenter studies with larger sample sizes are recommended

Depression is associated with the nonmotor symptoms of Parkinson's disease: A comparative analysis

Abstract Background and aims The nonmotor symptoms (NMS) of Parkinson's disease (PD) and their potential role in early diagnosis are recent debates. Herein, we aimed to investigate the association between depression and NMS of PD including sleep disorders, hyposexuality, hyposmia, constipation, and orthostatic hypotension. Methods A total of 93 PD patients with depression and 67 PD patients without depression were included in the study, and NMS were compared between the two groups. Furthermore, the possible associations between depression severity measured by Beck Depression Inventory (BDI) and NMS were investigated using linear regression or binary logistic regression models controlled for possible confounders. Eventually, we performed a subgroup analysis in each mild, moderate, and severe depression group. Results Orthostatic hypotension, constipation, and hyposexuality showed a significant difference between PD patients with and without depression (p < 0.001, p = 0.029, and p < 0.001, respectively). The BDI score was significantly associated with hyposexuality, Montreal cognitive assessment (MoCA), and Pittsburgh Sleep Quality (p = 0.016, p = 0.010, and p = 0.011, respectively); however, after adjustments for possible confounders, the associations of the BDI score with the MoCA score and hyposexuality remained significant (p = 0.015 and p = 0.019, respectively). Considering subgroup analysis, a similar pattern of significant results was observed particularly in the severe group. Conclusions This study suggests a possible association between depression in PD patients and some NMS observed in the course of PD. These findings could be beneficial for early diagnosis of the disease, which eventually could make a considerable difference in the management of PD patients. Additional interventional longitudinal studies are warranted to explore how controlling depression could impact the NMS of patients with PD