Patients with schizophrenia who take antipsychotic medications appear to lose a small but measurable amount of brain tissue over time, according to a report in the February issue of Archives of General Psychiatry.

Schizophrenia affects 1 percent of the worldwide population and remains a leading cause of chronic disability among young adults, according to background information in the article. Progressive changes in brain volume observed in patients with schizophrenia have been thought to be an effect of the disease. “However, recent animal studies indicate that antipsychotics, the mainstay of treatment for schizophrenia patients, may also contribute to brain tissue volume decrement,” the authors write. “Because antipsychotics are prescribed for long periods for schizophrenia patients and have increasingly widespread use in other psychiatric disorders, it is imperative to determine their long-term effects on the human brain.”

Beng-Choon Ho, M.R.C.Psych., and colleagues at University of Iowa Carver College of Medicine, Iowa City, studied 211 patients with schizophrenia who underwent repeated neuroimaging beginning soon after their illness. each patient had an average of three magnetic resonance imaging (MRI) scans over 7.2 years, for a total of 674 scans. the authors then assessed the relative contributions of four predictors—illness duration, antipsychotic treatment, illness severity and substance abuse—on changes in brain volume over time.

Patients who were followed for longer periods of time experienced more reductions in brain volume. Antipsychotic treatment was also associated with brain tissue reduction after controlling for the other three predictors. More intense antipsychotic treatment was associated with overall measures of brain tissue loss, smaller gray matter volume and progressive declines in white matter volume.

The other two variables, illness severity and substance abuse, had no or minimal association with brain changes after the effects of illness duration and antipsychotic treatment were considered.

“Findings from the present study raise several clinical questions. are antipsychotic-associated gray matter and white matter volume reductions ‘bad’ for patients?” the authors write. Although they are assumed to be undesirable, the benefits of long-term treatment may outweigh the risks, they note. “However, our findings point toward the importance of prescribing the lowest doses necessary to control symptoms.”

In addition, the results raise concerns about the use of antipsychotics for people who do not have schizophrenia, including children, older adults and patients with bipolar or depressive disorders.

“Antipsychotics are effective medications for reducing some of the target clinical symptoms of schizophrenia: psychotic symptoms. In medicine we are aware of many instances in which improving target symptoms worsens other symptoms,” the authors conclude. “It is possible that, although antipsychotics relieve psychosis and its attendant suffering, these drugs may not arrest the pathophysiologic processes underlying schizophrenia and may even aggravate progressive brain tissue volume reductions.”

More information: Arch Gen Psychiatry. 2011;68[2]:128-137.

Provided by JAMA and Archives Journals (news : web)

Xopenex (levalbuterol) is an inhaled medication for the treatment of acute asthma symptoms, including coughing, wheezing, shortness of breath and chest tightness. Xopenex (which contains R-albuterol) is the active isomer of albuterol (which contains a racemic mixture of both R- and S-isomers) Xopenex was first developed because animal studies suggested that S-albuterol caused inflammation in the lungs, which could possibly worsen asthma. it was also thought that as more racemic albuterol (mixture of the R and S-albuterol isomers) was taken, the S-albuterol isomer would accumulate within the lungs and worsen asthma symptoms. Xopenex was therefore expected to work better at treating asthma symptoms than racemic albuterol.

Albuterol is well-known to cause certain side effects, including muscle tremors, jitteriness, palpitations and increased heart rate. Early studies on Xopenex suggested that because far less medicine was needed to achieve the same benefit as albuterol, fewer side effects would occur. In addition, it was initially thought that the S-albuterol isomer was primarily responsible for many of the albuterol side effects, and therefore Xopenex, which does not contain the S-albuterol isomer, would cause few side effects.

But more recent studies show something quite surprising…

Read more:

• Xopenex versus Albuterol
• Are ProAir, Ventolin and Proventil different?
• 8 Things You should Do for Your Asthma

As men age they often experience prostate problems, like gettingup several times at night to go to the bathroom. Having to get upat night is a burden that can disturb a restful sleep, for both youand your partner. benign prostatic hypertrophy (BPH) is thenoncancerous enlargement of the prostate gland and is an extremelycommon condition in older men, effecting almost 50 percent by age60. The symptoms of BPH are frequent urination, dribbling,incomplete emptying of the bladder, and a weak stream of urine.

The causes of BPH are not well understood, but aging andtestosterone are believed to be the primary influences on itsdevelopment. Animal studies suggest that as males age theirhormonal balance between testosterone and estrogen (produced insmall amounts) becomes altered due to the decline in production oftestosterone. There are plenty of treatments – both medical andsurgical – but it would be ideal if the condition could beprevented in the first place through diet.

Two of the largest research studies (over 4700 men) looking atthe effects of diet on BPH were recently published in the Journalof Urology and in the American Journal of Epidemiology. to sum up,they found that taking dietary supplements (specificallyantioxidants) has less impact on a man’s risk of developing BPHthan does his overall eating pattern. The risk of developing BPHwas lower among men who followed diets high in protein andvegetables and low in fat and red meat and who regularly consumedalcohol in moderation. They recommend following these four tips tolower your risk for BPH:

* Get high levels of physical activity and reduce “bellyfat”

* Follow a low-fat diet

* Consume five or more servings of vegetables a day

* Consume no more than two glasses of alcohol a day

Translated – a prostate-healthy way to eat lunch may be tochoose salads without fatty mayonnaise-based dressings, fresh fruitand low-fat yogurt, or a wrap sandwich filled with hummus andvegetables. for dinner, opt for fish, chicken, soy or bean dishes,keeping the protein portion of the meal to no more than one-quarterof the plate, keeping starch to one- quarter and filling the restwith vegetables.

Gentlemen take note: a healthy prostate is yet another reason toeat your vegetables, keep fat intake low, exercise and enjoy anoccasional drink. Warning: prostate disorders can only be diagnosedby a physician. if you are experiencing symptoms associated withBPH you should see your physician immediately for properdiagnoses.

As men age they often experience prostate problems, like gettingup several times at night to go to the bathroom. Having to get upat night is a burden that can disturb a restful sleep, for both youand your partner. benign prostatic hypertrophy (BPH) is thenoncancerous enlargement of the prostate gland and is an extremelycommon condition in older men, effecting almost 50 percent by age60. The symptoms of BPH are frequent urination, dribbling,incomplete emptying of the bladder, and a weak stream of urine.

The causes of BPH are not well understood, but aging andtestosterone are believed to be the

primary influences on its development. Animal studies suggestthat as males age their hormonal balance between testosterone andestrogen (produced in small amounts) becomes altered due to thedecline in production of testosterone. There are plenty oftreatments – both medical and surgical – but it would be ideal ifthe condition could be prevented in the first place throughdiet.

Two of the largest research studies (over 4700 men) looking atthe effects of diet on BPH were recently published in the Journalof Urology and in the American Journal of Epidemiology. to sum up,they found that taking dietary supplements (specificallyantioxidants) has less impact on a man’s risk of developing BPHthan does his overall eating pattern. The risk of developing BPHwas lower among men who followed diets high in protein andvegetables and low in fat and red meat and who regularly consumedalcohol in moderation. They recommend following these four tips tolower your risk for BPH:

* Get high levels of physical activity and reduce “bellyfat”

* Follow a low-fat diet

* Consume five or more servings of vegetables a day

* Consume no more than two glasses of alcohol a day

Translated – a prostate-healthy way to eat lunch may be tochoose salads without fatty mayonnaise-based dressings, fresh fruitand low-fat yogurt, or a wrap sandwich filled with hummus andvegetables. for dinner, opt for fish, chicken, soy or bean dishes,keeping the protein portion of the meal to no more than one-quarterof the plate, keeping starch to one- quarter and filling the restwith vegetables.

Gentlemen take note: a healthy prostate is yet another reason toeat your vegetables, keep fat intake low, exercise and enjoy anoccasional drink. Warning: prostate disorders can only be diagnosedby a physician. if you are experiencing symptoms associated withBPH you should see your physician immediately for properdiagnoses.

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