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Daily GLP-1 Agonist Injection Aids Weight Loss in Patients Without Diabetes
A once-daily subcutaneous injection of 3.0 mg of liraglutide, along with diet and exercise, is showing promise as an effective weight-management treatment. The industry-supported study, published recently by the New England Journal of Medicine, reported that two-thirds of patients on the injectable glucagonlike peptide-1 receptor (GLP-1) agonist lost at least 5% of their body weight, compared with just more than a quarter of those on placebo. Participants in the 56-week double-blind study did not have type 2 diabetes, but had a body-mass index of at least 30 or slightly less if they had treated or untreated dyslipidemia or hypertension.
Watch Out for ADHD Stimulant Use in Heart Rhythm Disorder Patients
Stimulants for attention-deficit/hyperactivity disorder (ADHD) can be risky in patients with long-QT syndrome (LQTS). Although LQTS may be relatively rare, with one recent study estimating the prevalence at about 1 in 2,000 prescriptions for ADHD medications are anything but, with more than 3.5 million children receiving them. A study published recently in the Journal of Cardiovascular Electrophysiology found a 62% cumulative probability of cardiac events in patients with LQTS receiving stimulants for ADHD treatment, compared to 28% in the control group. The risk was even greater with long-term use and in males.
Less Relief, More Opioid Misuse in Depressed/Anxious Back Pain Patients
Here's why opioids are an especially bad idea for treating lower back pain in patients with psychiatric disorders: Those users received significantly less relief than other patients and were much more likely to abuse their medications. A study published online recently by the journal Anesthesiology looked at the effects of morphine, oxycodone, or a placebo administered over 6 months to patients with concurrent back pain and depression/anxiety. Participants with mental health issues experienced 50% less improvement in back pain, 75% more opioid abuse, and increased overall side effects when compared to patients with low levels of depression or anxiety symptoms.
When to Lower Antipsychotic Dosages in Older Patients
When is an antipsychotic dosage decrease appropriate in older patients? The question is especially important because patients with late-life schizophrenia (LLS) are much more susceptible to antipsychotic adverse effects. An article appearing in JAMA Psychiatry offers an answer, suggesting that antipsychotic dose reduction is feasible in patients with stable LLS, decreasing adverse effects and improving illness severity measures. The study focused on 35 outpatients, all age 50 years or older, with clinically stable LLS and who were receiving olanzapine or risperidone monotherapy at the same dose for 6 to 12 months. Participants underwent a gradual dose reduction of up to 40%, with average dopamine D2/3R occupancies dropping from 70% to 64% after the dosage reduction.
