Schizophrenia is often a severe and disabling illness that affects approximately one per cent of the worldwide population. Schizophrenia has 'positive' symptoms, such as strange and fixed beliefs (delusions), as well as hearing voices and seeing things (hallucinations). Schizophrenia also has 'negative' symptoms such as apathy, loss of emotion, lack of drive and disorganisation of behaviour and thought. The degree of disability is considerable with 80% - 90% not working and up to 10% dying.
Antipsychotic drugs are the main treatment for schizophrenia, and are grouped into older drugs (first generation or ‘typical’) and newer drugs (second generation or ‘atypical’). However, antipsychotic drugs also have serious side effects, particularly movement disorders such as uncontrollable shaking, tremors, muscle stiffness, tiredness, weight gain and the inability to sit still.
Perazine is an older antipsychotic drug first introduced in the 1950s. It is suggested to have a low level of side effects (especially for movement disorders). Its use is regional and restricted to countries like Germany, Poland, the Netherlands and the former Yugoslavia.
A search for trials was carried out in July 2012. The review now includes seven studies with a total of 479 participants and assesses the effects of perazine for people with schizophrenia. Comparisons of perazine versus placebo (‘dummy’ treatment) and versus other antipsychotic drugs revealed no clear differences or superiority of perazine. However, only a handful of studies have been undertaken and the number of participants in each study was small. In addition the studies avialable were of limited quality with data for the main outcomes of interest rated as low or very low quality. As perazine is a cheap drug and there is some limited evidence that it may cause less side effects than other older antipsychotic drugs, further large scale, well designed and well-reported studies are much needed.
Monday 10 February 2014
Physical health care monitoring for people with serious mental illness.
People with mental health problems often have complex and long-term difficulties with their physical health such as weight gain, smoking and heart problems. They sometimes do not take care of themselves, have inactive lifestyles and may not be able to cope with daily life or work. People with mental health problems have higher rates of diabetes, lung disease, cancer, heart problems, HIV/Aids and other infectious diseases.
Physical health care monitoring can take a variety of forms from simple checks carried out by the person themselves to complex specific health checks carried out by health professionals. Monitoring helps identify current health problems and also anticipate future health problems.
In August 2006 the United Kingdom’s Department of Health issued guidance on how to provide better care for the physical health needs of people with serious mental illness. Spearhead Trusts, the Royal College of Psychiatrists, the National Institute for Clinical Excellence and other organisations all promoted the use of physical health care monitoring for people with mental health problems.
This review intended to find evidence to support this guidance. The authors’ conclude that current guidance and practice on physical health monitoring lacks a firm basis in research and there is little evidence to support this growing trend. They based their conclusions on results from a search carried out for trials in 2012 which found no relevant randomised studies. Current monitoring is mainly based on the agreement of experts, medical experience and good intentions. This does not mean that physical health monitoring is invalid, wrong or not of benefit to the physical health of people with severe mental illness, only that there is as yet no definite proof. Physical health care monitoring has the potential and promise to improve quality of life and help people with mental health problems live longer, but at this stage the information is uncertain and the research evidence unclear.
Physical health care monitoring can take a variety of forms from simple checks carried out by the person themselves to complex specific health checks carried out by health professionals. Monitoring helps identify current health problems and also anticipate future health problems.
In August 2006 the United Kingdom’s Department of Health issued guidance on how to provide better care for the physical health needs of people with serious mental illness. Spearhead Trusts, the Royal College of Psychiatrists, the National Institute for Clinical Excellence and other organisations all promoted the use of physical health care monitoring for people with mental health problems.
This review intended to find evidence to support this guidance. The authors’ conclude that current guidance and practice on physical health monitoring lacks a firm basis in research and there is little evidence to support this growing trend. They based their conclusions on results from a search carried out for trials in 2012 which found no relevant randomised studies. Current monitoring is mainly based on the agreement of experts, medical experience and good intentions. This does not mean that physical health monitoring is invalid, wrong or not of benefit to the physical health of people with severe mental illness, only that there is as yet no definite proof. Physical health care monitoring has the potential and promise to improve quality of life and help people with mental health problems live longer, but at this stage the information is uncertain and the research evidence unclear.
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