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Xu X, Shao G, Zhang X, Hu Y, Huang J, Su Y, Zhang M, Cai Y, Zhou H. The efficacy of nutritional supplements for the adjunctive treatment of schizophrenia in adults: A systematic review and network meta-analysis. Psychiatry Res 2022; 311:114500. [PMID: 35287043 DOI: 10.1016/j.psychres.2022.114500] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 12/19/2022]
Abstract
Nutritional supplementations have been widely used as adjunctive treatments for schizophrenia. However, among these supplementations, of which the most beneficial is currently unknown. This study aimed to compare and rank the effectiveness of nutritional supplementations in the adjunctive treatments of schizophrenia. The four nutritional supplementations evaluated were: 1) folate acid or vitamin B12; 2) vitamin D; 3) N-acetyl cysteine (NAC); 4) Omega-3 polyunsaturated fatty acid, including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). 17 eligible RCTs with 1165 participants were included in this network meta-analysis based on study criteria. NAC supplementation was significantly more efficacious than folic acid or vitamin B12 [MD (95% CI): -6.6 (-10.8, -2.4)] and omega-3 polyunsaturated fatty acid [MD (95% CI): -5.1(-9.9, -0.8)] supplementation in the term of PANSS score changes. There were no significant differences in the PANSS score changes between NAC and vitamin D [MD (95% CI): -5.2 (-10.9, 0.5)] supplementations. The estimated ranking probabilities of treatments showed that NAC might be the most effective adjunctive intervention over all nutritional supplementations. These results indicate that NAC could improve PANSS score and it may be among the most effective nutritional supplementations in schizophrenia patients.
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Affiliation(s)
- Xianrong Xu
- Departmemnt of Nutrition and toxicology, School of Public Health, Hangzhou Normal University, Hangzhou, 311121, PR China
| | - Ge Shao
- Departmemnt of Nutrition and toxicology, School of Public Health, Hangzhou Normal University, Hangzhou, 311121, PR China; School of Public Health, Shanghai Medical College, Fudan University, Shanghai, 200032, PR China
| | - Xu Zhang
- Departmemnt of Nutrition and toxicology, School of Public Health, Hangzhou Normal University, Hangzhou, 311121, PR China
| | - Yan Hu
- Departmemnt of Nutrition and toxicology, School of Public Health, Hangzhou Normal University, Hangzhou, 311121, PR China
| | - Jia Huang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, PR China
| | - Yousong Su
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, PR China
| | - Min Zhang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, PR China
| | - Yiyun Cai
- Department of Psychiatry, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, PR China.
| | - Huiping Zhou
- Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University , Hangzhou, 310021, PR China.
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Jin L, Chen Y, Zhu J, Huang Q, Li B, Xu Y, Xi R, Lu W. The Willingness of Community Psychiatric Management Physicians to Preferentially Recommend Long-Acting Injections in Beijing. Front Public Health 2021; 9:779563. [PMID: 34869192 PMCID: PMC8639574 DOI: 10.3389/fpubh.2021.779563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 10/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Severe mental disorders (SMD) impose a heavy burden on individuals, society, and the country. Under the background of deinstitutionalization, more and more patients return to the community, and the community psychiatric management physicians (CPMP) play an essential role in this process. Long-acting injection (LAI) is an important way to improve compliance and reduce re-hospitalization. Some districts in Beijing have implemented the policy of free LAI. This article aims to find out the willingness of CPMP to preferentially recommend LAI and provide suggestions for follow-up promotion. Methods: All CPMP in 16 districts of Beijing were surveyed. A self-made electronic questionnaire was used to investigate the willingness to recommend LAI in priority. Descriptive statistics, Chi-square test, and logistic regression were used to analyze the data. Results: The willingness of CPMP to preferentially recommend LAI is up to 80%. Participants aged 40–49, female, with higher self-evaluation of psychiatric management knowledge, managing patients who have used LAI in the past, and working in communities with the free LAI policy have higher willingness to recommend LAI in priority. Conclusion: CPMP in Beijing have a positive attitude toward LAI, and most of them have the willingness to recommend LAI to the patients in priority. The recommendation willingness is the basis of prescription decision-making. Therefore, the coverage of free LAI policy should be further expanded in the future to improve the recommendation willingness and thus improve the injection rate of LAI.
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Affiliation(s)
- Lefan Jin
- School of Public Health, Capital Medical University, Beijing, China.,Research Center for Capital Health Management and Policy, Beijing, China
| | - Yun Chen
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Policy Research Office, Beijing Institute of Mental Health, Beijing, China
| | - Junli Zhu
- School of Public Health, Capital Medical University, Beijing, China.,Research Center for Capital Health Management and Policy, Beijing, China
| | - Qingzhi Huang
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Policy Research Office, Beijing Institute of Mental Health, Beijing, China
| | - Bin Li
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Policy Research Office, Beijing Institute of Mental Health, Beijing, China
| | - Ying Xu
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Policy Research Office, Beijing Institute of Mental Health, Beijing, China
| | - Rui Xi
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Policy Research Office, Beijing Institute of Mental Health, Beijing, China
| | - Wei Lu
- School of Public Health, Capital Medical University, Beijing, China.,Research Center for Capital Health Management and Policy, Beijing, China
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Wang L, Shi F, Guan X, Xu H, Liu J, Li H. A Systematic Review of Methods and Study Quality of Economic Evaluations for the Treatment of Schizophrenia. Front Public Health 2021; 9:689123. [PMID: 34746073 PMCID: PMC8564012 DOI: 10.3389/fpubh.2021.689123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 09/21/2021] [Indexed: 02/03/2023] Open
Abstract
Background: Schizophrenia is a severe and complex disease with substantial economic and social burdens. Despite multiple treatment choices, adverse events, and impaired social functions are still challenges in clinical therapy. Pharmacoeconomic evaluations could provide evidence to help decision makers improve the utilization of scarce resources. However, there remains some challenges especially in modeling due to uncertainties in progression of schizophrenia. There are limited summaries about the overall methodologies of schizophrenia economic evaluations. Objective: The aim of this study is to review the existing economic evaluations of antipsychotics for the treatment of schizophrenia and summarize the evidence and methods applied. Methods: An electronic literature search was performed in PubMed, Web of Science, EBSCO host, The Cochrane Library and ScienceDirect from January 2014 to December 2020. Search terms included “schizophrenia,” “schizophrenic,” “pharmacoeconomic,” “economic evaluation,” “cost-effectiveness,” and “cost-utility.” The Literature was screened and extracted by two researchers independently and assessed with the Quality of Health Economic Studies (QHES) List and Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Statement. Results: A total of 25 studies were included in the review. The regions included Europe, North America, Asia and Africa. Most of the studies chose second-generation antipsychotics as comparators and integrated treatment sequences. Time horizons varied from 1 year to lifetime. The healthcare sector was the most common perspective, accordingly, most of the evaluations considered only direct medical costs. The Markov model and decision tree model were the most common choices. Adverse events, compliance and persistence were considered important parameters. Quality-adjusted life-years were the major outcomes applied to the economic evaluations. All utilities for health states and adverse events were collected from published literature. All of the studies applied uncertainty analysis to explore the robustness of the results. The quality of the studies was generally satisfactory. However, improvements were needed in the choice of time horizons, the measurements of outcomes and the descriptions of assumptions. Conclusions: This study highlights the methodology of economic evaluation of schizophrenia. Recommendations for modeling method and future study are provided.
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Affiliation(s)
- Luying Wang
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.,Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, China
| | - Fenghao Shi
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.,Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, China
| | - Xin Guan
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.,Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, China
| | - He Xu
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.,Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, China
| | - Jing Liu
- Sumitomo Pharma (Suzhou) Co., Ltd., Shanghai, China
| | - Hongchao Li
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.,Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, China
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Zhang W, She X, Wang L, Fan H, Zhou Q, Huang X, Tang JZ. Preparation, Characterization and Application of a Molecularly Imprinted Polymer for Selective Recognition of Sulpiride. MATERIALS (BASEL, SWITZERLAND) 2017; 10:E475. [PMID: 28772831 PMCID: PMC5459076 DOI: 10.3390/ma10050475] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 04/09/2017] [Accepted: 04/24/2017] [Indexed: 11/30/2022]
Abstract
A novel molecular imprinting polymer (MIP) was prepared by bulk polymerization using sulpiride as the template molecule, itaconic acid (ITA) as the functional monomer and ethylene glycol dimethacrylate (EGDMA) as the crosslinker. The formation of the MIP was determined as the molar ratio of sulpiride-ITA-EGDMA of 1:4:15 by single-factor experiments. The MIP showed good adsorption property with imprinting factor α of 5.36 and maximum adsorption capacity of 61.13 μmol/g, and was characterized by scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FT-IR) and surface area analysis. With the structural analogs (amisulpride, tiapride, lidocaine and cisapride) and small molecules containing a mono-functional group (p-toluenesulfonamide, formamide and 1-methylpyrrolidine) as substrates, static adsorption, kinetic adsorption, and rebinding experiments were also performed to investigate the selective adsorption ability, kinetic characteristic, and recognition mechanism of the MIP. A serial study suggested that the highly selective recognition ability of the MIP mainly depended on binding sites provided by N-functional groups of amide and amine. Moreover, the MIP as solid-phase extractant was successfully applied to extraction of sulpiride from the mixed solution (consisted of p-toluenesulfonamide, sulfamethoxazole, sulfanilamide, p-nitroaniline, acetanilide and trimethoprim) and serum sample, and extraction recoveries ranged from 81.57% to 86.63%. The tentative tests of drug release in stimulated intestinal fluid (pH 6.8) demonstrated that the tablet with the MIP-sulpiride could obviously inhibit sulpiride release rate. Thus, ITA-based MIP is an efficient and promising alternative to solid-phase adsorbent for extraction of sulpiride and removal of interferences in biosample analysis, and could be used as a potential carrier for controlled drug release.
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Affiliation(s)
- Wei Zhang
- School of Basic Courses, Guangdong Pharmaceutical University, Guangzhou 510006, China.
| | - Xuhui She
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, China.
- Guangzhou KingMed Center for Clinical Laboratory Co., Ltd., Guangzhou 510005, China.
| | - Liping Wang
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, China.
- China National Analytical Center Guangzhou, Guangzhou 510070, China.
| | - Huajun Fan
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, China.
| | - Qing Zhou
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, China.
| | - Xiaowen Huang
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, China.
| | - James Z Tang
- Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton WV1 1LY, UK.
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