L-lysine as an adjunct to risperidone in patients with chronic schizophrenia: a double-blind, placebo-controlled, randomized trial.

UNLABELLED: Increasing evidence suggest that the nitric oxide signaling system of the brain may contribute to the pathophysiology of schizophrenia, making this system a target for development of novel therapeutics. The objective of this study was to investigate the efficacy and safety of L-lysine as an adjunctive to risperidone in the treatment of patients with chronic schizophrenia during an 8-week trial. Seventy-two chronic schizophrenia inpatients with a Positive and Negative Syndrome Scale (PANSS) total score of ≥ 60 participated in a randomized, double-blind, placebo-controlled trial in the active phase of their disease and underwent 8 weeks of treatment with either L-lysine (6 g/day) or placebo as an adjunctive to risperidone. Patients were evaluated using PANSS and its subscales at baseline and weeks 2, 4, 6 and 8. The primary outcome measure was to evaluate the efficacy of L-lysine in improving schizophrenia symptoms. Repeated measures analysis demonstrated significant effect for time × treatment interaction on the PANSS total (P < 0.001), negative (P < 0.001) and general psychopathology (P < 0.001) subscale scores but not the PANSS positive subscale scores (P = 0.61). The frequency of adverse events (AEs) did not differ significantly between the two treatment groups and no serious AE was observed. The present study demonstrated that l-lysine can be a tolerable and efficacious adjunctive therapy for improving negative and general psychopathology symptoms in chronic schizophrenia. However, the safety and efficacy of higher doses of l-lysine and longer treatment periods still remain unknown. TRIAL REGISTRATION: Iranian registry of clinical trials (www.irct.ir): IRCT201202201556N33.

Undiagnosed Bipolar Disorders in Patients with Major Depressive Episode: Iran's part of a Multicenter Cross-Sectional Study.

OBJECTIVE: Bipolar spectrum disorders may often go undiagnosed or unrecognized. The aim of this study was to determine the proportion of bipolar disorder symptoms in Iranian patients with a major depressive episode. METHODS: 313 patients with a current DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders 4th ed. Text rev.) diagnosed with a major depressive episode entered this cross-sectional study. Thirty two items revised Hypomania/ mania Symptoms Checklist (HCL-32) was used to determine the frequency of bipolar episodes. RESULTS: Considerable proportion of patients (53.9%) previously diagnosed as major depressive disorder fulfilled the criteria for bipolar disorder by Bipolarity Specifier. The Bipolarity Specifier additionally identified significant association for manic / hypomanic states during antidepressants therapy (p<0.0003) and current mixed mood symptoms (p<0.0001). CONCLUSION: Bipolar symptoms meeting the criteria for bipolar disorders in depressed patients who have not been previously diagnosed with bipolar disorder are frequent. Current DSM criteria may not be sufficient to diagnose more subtle or atypical forms of bipolar disorders.

Association between environmental factors and risk of type 1 diabetes - a case-control study.

INTRODUCTION: While many studies support the theory that environmental factors play a role in the development of type 1 diabetes mellitus (T1DM), controversy exists as to the contribution of any individual factor. The aim of the present study was therefore to investigate the associations of T1DM with several environmental factors. MATERIAL AND METHODS: A case-control study was conducted on children £ 16 years old who were diagnosed with T1DM and healthy age and sex-matched controls. Data regarding the socio-demographic status, gestational and neonatal risk factors were evaluated. RESULTS: One hundred and one children with T1DM (41 males and 60 females), and the same number of age- and sex-matched controls, were included in the present study (mean age 10.3 ± 4.5 years). On multivariable logistic regression analysis, maternal age > 35 years at delivery, duration of > 6 months of cow milk feeding, lack of vitamin D supplementation and caesarean delivery were significantly associated with diabetes. CONCLUSION: In the present case-control study, certain environmental risk factors were associated with the development of T1DM.