Evaluation of the Effect of Barberry Root (Berberis Vulgaris) on the Prevention of Metabolic Syndrome Caused by Atypical Antipsychotic Drugs in Patients with Schizophrenia: A Three-Blind Placebo-Controlled Clinical Trial

Objective: Metabolic syndrome is a potential side effect of atypical antipsychotics which are the current standard treatment for schizophrenia. Therefore, we aimed to examine the effect of barberry root (Berberis vulgaris) on the prevention of metabolic syndrome caused by atypical antipsychotic drugs in patients with schizophrenia. Method : Our research was a three-blind randomized clinical trial. The participants included all patients who were diagnosed with schizophrenia through the SCID-5 questionnaire and based on the DSM-5-TR criteria by two psychiatric experts. These patients were randomly divided into intervention and placebo groups. During a three-month treatment period, the intervention group received three 500 mg capsules of barberry root extract daily, whereas the placebo group received the same capsules containing 500 mg of starch powder. Metabolic syndrome variables including fasting blood glucose, serum lipids (triglyceride and cholesterol), blood pressure, weight and waist circumference were measured before and after the treatment as outcome measure. Chi-square and t-tests were used for data analysis using SPSS-22 software. Results: At the beginning of the study, there was no significant difference between the intervention group (n = 41) and the placebo group (n = 47) in terms of demographic factors, and pre-treatment assessments including weight, waist size, fasting blood HDL, fasting blood triglycerides and systolic and diastolic blood pressure and fasting blood glucose (P > 0.05). Within group analysis showed that some metabolic factors significantly increased in both groups after the treatment (P < 0.05). Indeed, in both groups, metabolic syndrome measures worsened after the three-month treatment period. The parameters of weight and waist size were significantly higher in the intervention group than the placebo group after treatment (P < 0.05). Conclusion: Barberry root extract was not able to control the Effects of antipsychotic drugs on metabolic syndrome in schizophrenia.

Evaluating the Effect of Melatonin on Positive and Negative Symptoms of Schizophrenic Patients: A Randomized Placebo-Controlled Study

Objective: Schizophrenia is known as a severe psychiatric disorder with a broad range of clinical indications and symptoms such as positive and negative symptoms. This study was conducted with the aim of investigating the effect of melatonin on positive and negative symptoms of inpatients with schizophrenia. Method: This study was conducted as a randomized placebo-controlled trial (double-blind) in the population of patients with schizophrenia. Study samples were selected from inpatients with schizophrenia, according to the DSM-5 criteria, who had not been diagnosed with a depressive episode of schizophrenia based on the Calgary questionnaire and who also met the inclusion criteria. 46 patients with schizophrenia were randomly assigned to the intervention (6 mg melatonin per day as two 3 mg pills for six weeks) and placebo groups. The positive and negative symptom scale (PANSS) was used to assess the effect of treatment at T1 (before intervention), T2 (three weeks after beginning the intervention) and T3 (six weeks after beginning the intervention). To check the research hypotheses, multiple comparison statistics were used by the SPSS 22 software. Results: The placebo and melatonin groups had no significant difference in terms of PANSS scores (negative, positive, general and total symptom scores) at T1. Also, there was no difference in PANSS scores between the two groups at T2. However, at T3, there was a significant difference between the two groups only in the score of negative symptoms of PANSS (P = 0.036), so that negative symptoms of schizophrenia were significantly reduced in the intervention group compared to the placebo group. Furthermore, based on within-group analyzes, all PANSS scores were significantly reduced in the two groups at T2 and T3 (P < 0.05). Conclusion: Long-term use (at least six weeks) of melatonin can improve the negative symptoms of schizophrenia. Since antipsychotics can better affect the positive symptoms, the use of melatonin in combination with these drugs may perhaps further improve the patients’ symptoms.

Investigating the effect of magnesium supplement in patients with major depressive disorder under selective serotonin reuptake inhibitor treatment

Background

Major depression disorder (MDD) is a mental disorder that affects millions of people worldwide. This disease has negative impacts on quality of life and psychological-related functions. This is a multifactorial disorder; both genetic background and environmental factors have their role. Antidepressants are prescribed as the first line of treatment for patients with depressive disorders. Selective serotonin reuptake inhibitor (SSRI) antidepressants are used to treat MDD and anxiety; however, some patients do not respond to them. Regarding that, magnesium plays a major role in mood regulation; therefore, this study aimed to investigate the role of magnesium supplement in patients with MDD and under an SSRI treatment regimen.

Methods

In this randomized, double-blind controlled trial, 60 patients with major depressive disorders based on the DSM-V diagnosis referred to Golestan Hospital in Ahvaz, Iran, were included. The eligible patients were categorized randomly into two thirty-people groups receiving magnesium (intervention) and placebo (control) along with SSRI for 6 weeks. To evaluate the depression status, the Beck II test was applied. Subjects were examined before and after the intervention.

Results

There was no statistically significant difference between the two groups in terms of demographic characteristics (P > 0.05). The mean Beck scores at the beginning of the study and the second week after the intervention were not different between the two groups (P = 0.97, P = 0.56), whereas the mean Beck scores were lower in the intervention group than in the control group in the fourth and sixth weeks after the intervention (P = 0.02 and P = 0.001, respectively).

Conclusion

Administration of Mg supplement for at least 6 weeks might improve depression symptoms. It can also be considered as a potential adjunct treatment option for MDD patients who are under SSRI treatment.

Rhus coriaria L., a new candidate for controlling metabolic syndrome: a systematic review

OBJECTIVES

Rhus coriaria L. (RC) is a deciduous shrub with several pharmacological activities. Evidence of the effects of RC on weight, hyperlipidaemia, hypertension and diabetes mellitus have been presented in this study. Books, thesis and internet-based resources such as PubMed, Web of Science, Scopus, EMBASE, Cochrane, Ovid and Google Scholar were searched for the English, Arabic and Persian literature from 1966 to 2020 (December). The keywords were Rhus coriaria L., Sumac, metabolic syndrome and all its medical conditions (hyperlipidaemia, hypertension, obesity and diabetes mellitus). The inclusion criteria were full-text animal and human studies conducted on RC to evaluate its efficacy on any components of metabolic syndrome (MetS). Jadad scale was used to assess the quality of evidence.

KEY FINDINGS

Reviewing 23 relevant studies demonstrated that RC is able to decrease the level of blood glucose, glycated haemoglobin, serum insulin and insulin resistance. Studies on hyperlipidaemia and obesity have very contradicting results, and there is no definite conclusion on the effect of RC on lipid profile. However, the hypotensive and effect of RC was confirmed in the existing studies.

SUMMARY

According to the literature, RC can be considered as a promising curative candidate for MetS. However, further studies with larger sample size and higher methodological quality are needed.

The mediating role of self-compassion in the relationship between positive reactivity, negative reactivity, and perfectionism with disordered eating

BACKGROUND

Individuals with disordered eating are at an increased of having one or more additional risks for comorbid disorders, such as anxiety disorder, depressive disorder, and insomnia. Therefore, the present study aimed to investigate the mediating role of self-compassion in the relationship between positive reactivity, negative reactivity, and perfectionism with disordered eating.

MATERIALS AND METHODS

The study method was descriptive-correlational through structural equation modeling (SEM). The present study population included all students of the University of Tehran in the city of Tehran in 2018-2019. A total of 302 students were selected by convenience sampling method and completed questionnaires on eating attitudes test-8, self-compassion scale (short form), eating disorder inventory-perfectionism scale, and Perth emotional reactivity scale. The SEM path analysis and Pearson correlation coefficient were conducted to analyze the obtained data in SPSS-23 and Lisrel-8.80.

RESULTS

The finding of the path analysis showed that self-compassion acts as a mediating role in the relationship of disordered eating with positive and negative emotional reactivity and perfectionism. Only the direct effect coefficient of general positive reactivity on disordered eating was not significant.

CONCLUSION

Based on the results of this study, self-compassion can serve as a protective factor against negative emotional reactivity and perfectionism. Therefore, self-compassion can be considered in the development of prevention and treatment programs for disordered eating.

Effect of Cuscuta epithymum Acquainted with Risperidone on the Improvement of Clinical Symptoms and Cognitive Impairment in Patients with Schizophrenia: A Triple-Blind Randomized Placebo-Controlled Trial

Background:

Cuscuta epithymum (CE) is an established medicinal herb utilized for treating psychosis in Persian medicine. The aim of this study was to investigate the effect of CE combined with risperidone on the clinical symptoms and the cognitive impairment in patients diagnosed with schizophrenia.

Materials and Methods:

In this triple-blind randomized placebo-controlled trial, the intervention group received a dose of 500 mg of CE in the form of a capsule to be taken twice a day accompanied by an appropriate dose of risperidone. The control group was presented with a placebo identical to that of the CE capsule plus the allocated dose of risperidone. The PANSS and SCoRS questionnaires were used to assess the status of subjects prior to the initiation of the intervention as well as being put to use at the end of the second, fourth, and eighth week post-intervention. Registering and recording intel concerning positive and negative symptoms felt by participants (PANNS), and a test to assess the cognitive impairment of the individuals.

Results:

After eight weeks of treatment, all negative and positive symptoms besides hostility and somatic concern exhibited a significant improvement in the CE group (P <0.05). In contrast, the CE placebo group displayed no substantial improvement in the cases of the positive, negative and general symptoms (P>0.05) regarding cognitive impairment, after eight weeks of treatment, all symptoms were greatly improved in the CE group (P<0.05), while the effect of the placebo on the patients cognitive impairment remained mostly stationary (P>0.05). Consequently, after eight weeks after the intervention, we can determine that the CE treatment has been noticeably more effective at improving positive, negative and cognitive symptoms of patients with schizophrenia.

Conclusion:

The results of this study demonstrated that CE, possessing possible antioxidant and neuroprotective properties, safely improved the positive and negative symptoms, and cognitive impairment of patients with schizophrenia.

Comparison between the efficacies of Risperidone with Haloperidol in the treatment of attention-deficit hyperactivity disorder (ADHD) among preschoolers: a randomized double-blind clinical trial

BACKGROUND

Attention-deficit hyperactivity disorder (ADHD) is a common psychiatric disease with a worldwide pooled prevalence of 5.29%.

OBJECTIVE

To compare the efficacy of Risperidone with Haloperidol in the treatment of attention-deficit hyperactivity disorder (ADHD) among 3- to 6-year-old children.

METHODS

In a 6-week double-blind clinical trial, the efficacy of Risperidone 0.5-2 mg with a dose of maximum Haloperidol 0.075 mg/kg was assessed in 39 children aged 3-6 years. This study was conducted at the Golestan Psychiatric Clinic (Ahvaz, Iran). Measurement tools included the Conners' Parent Rating Scale (CPRS-48), Children's Global Assessment Scale (CGAS), and the Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS). Data were analyzed using the Wilcoxon, Mann-Whitney, and Fisher's exact tests in the SPSS 19.

RESULTS

During the 6 weeks, the decline in points was seen in Conner's rating scale and in ADHD-RS score in Risperidone and Haloperidol groups (p<0.001). On the CGAS scale, an increase of performance in both groups for six weeks was statistically significant (p<0.001). In the scales of ADHD-RS and CPRS-48, no statistically significant difference was observed between the two treatment groups; i.e., in terms of reducing the rate during weeks of two, four, and six (p>0.05).

CONCLUSIONS

Haloperidol and Risperidone possibly can be an acceptable treatment choice in the ADHD treatment of 3- to 6-year-old children.

TRIAL REGISTRATION

The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2015082623766N1.

FUNDING

This work was financially supported by grant (ref. no.: U-93130) from the vice chancellor for Research Affairs of Ahvaz Jundishapur University of Medical Sciences.