Journal/Magazine Articles
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This collection contains original research articles, review articles and case reports published in local and international peer reviewed journals by the staff members of the Faculty of Medicine
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Item Randomised, placebo-controlled trial on topiramate add-on therapy for weight reduction and symptomatology in overweight/obese persons with Schizophrenia(Elsevier Ltd, 2022) Chandradasa, M.; Ruwanpriya, S.; de Silva, S.; Rathnayake, L.; Kuruppuarachchi, K.A.L.A.Introduction: Higher cardiovascular mortality is seen with schizophrenia due to the disorder itself and antipsychotic use. South Asians are more vulnerable to developing metabolic disorders than others. Resource-limited settings in South Asia have only a few mental health professionals, and individualised case management is mostly unavailable. Therefore, there is less monitoring and personalised support for diet and physical exercise programmes. Topiramate is useful for weight reduction and improvement of psychopathology in schizophrenia. However, there has been only one previous randomised controlled trial (RCT) done in South Asia, which possesses a quarter of the world's population. Methods: We conducted a double-blind RCT in an outpatient setting in Sri Lanka. We compared topiramate 100 mg/day with a placebo in overweight/obese adults with schizophrenia who have been on antipsychotics for at least a year. We obtained monthly anthropometric measurements and assessed the symptomatology using the brief psychiatric rating scale (BPRS). Results: Fifty patients each in the topiramate and placebo arms completed the study. Topiramate add-on therapy led to significant weight/Body Mass Index reduction and improved symptomatology as measured by the BPRS compared to the placebo. The topiramate group had significantly more reporting of loss of appetite. Discussion: According to available data, this is the RCT with most participants assessing the use of topiramate in schizophrenia and only the second in South Asia. Topiramate was shown to be useful for weight reduction and symptomatic improvement in persons with schizophrenia in a resource-limited setting in South Asia.Item Betel-quid use and its effects on symptoms of schizophrenia and extrapyramidal symptoms among a group of patients in a tertiary care hospital in Sri Lanka.(Sri Lanka College of Psychiatrists, 2020) Isuru, A.; Ediriweera, D.; Pathmeswaran, A.; Embuldeniya, A.; Narammalage, H.; Warnakulasuriya, S.; Kuruppuarachchi, K.A.L.A.; Hapangama, A.BACKGROUND: There is limited research regarding the prevalence of betel quid use and its effects on symptoms of patients with schizophrenia. Available studies suggest an association between betel chewing and positive symptoms among males with schizophrenia. AIMS: This study aimed to compare the prevalence of betel quid chewing between patients with and without mental illness, and to explore the association between betel quid use, symptoms of schizophrenia and side effects of psychotropic medication. METHODS: A cross sectional descriptive study was carried atoutpatient clinics at a tertiary care hospital in Sri Lanka. A structured interview schedule was administered to all participants. RESULTS: Out of 1000 participants, 20.9% chewed betel quid (95%CI: 18.4% - 23.4%). The rate of betel chewing among patients with and without a mental illness was 20.7% (95% CI: 17.0% - 24.4%) and 21.0% (95% CI: 17.6% - 24.5%) respectively and there was no significant difference between the two groups. There was no statistically significant difference between the occurrence of positive or negative symptoms and extra pyramidal side effects in patients with schizophrenia who did and did not chew betel. Female gender (p=0.004) and betel quid chewing (0.002) were associated with more anticholinergic side effects. CONCLUSIONS: There was no association between betel quid usage and the occurrence of positive or negative symptoms of schizophrenia or extra pyramidal side effects. KEYWORDS: Schizophrenia, Betel quid, Positive symptoms, Negative symptoms, Extra pyramidal side effectsItem Erectile dysfunction among male patients diagnosed with schizophrenia being treated with antipsychotic medication, and the impact on quality of life(Sri Lanka College of Psychiatrists, 2018) Rowel, W. W. J. S. M .; Liyange, U. L. N. S.; Hewawitharana, U. H.; Dayabandara, M.; Rodrigo, A.INTRODUCTION:Erectile dysfunction is a distressing side effect of antipsychotics, which leads to poor medication compliance and poor quality of life. There is a scarcity of studies on antipsychotic-induced sexual dysfunction in Sri Lanka. We assessed the prevalence of erectile dysfunction among patients with schizophrenia who have been prescribed antipsychotic medication. METHODS : A cross sectional, descriptive study was conducted among patients attending the outpatient clinics of Colombo North Teaching Hospital and National Hospital, Sri Lanka. The five item International Index for Erectile Dysfunction, Erection Hardness Score and World Health Organization Quality of Life Brief Scale were used to assess erectile dysfunction and quality of life. RESULTS: Of the 102 patients in the study, 80 (79%) were found to have erectile dysfunction. The largest proportion of erec tile dysfunction was seen in patients who were prescribed clozapine (87.9%), followed by risperidone (82.1%), olanzapine (73.9%) and fluphenazine (68.8%). There was no significant correlation between erectile dysfunction and quality of life. None of the patients had initiated a discussion about sexual side effects, while only 8.3% reported that their psychiatrist had inquired about the sexual dysfunction. CONCLUSIONS: The results of this study suggest that sexual dysfunction is a common but often overlooked phenomenon among patients with schizophrenia. This study highlights the need for Sri Lankan psychiatrists to explore sexual problems in this cohort of patients.Item Association of duration of untreated psychosis and functional level, in first episode of schizophrenia attendingan outpatient clinic in Sri Lanka(Postgraduate Institute of Medicine, University of Colombo, 2016) Chandradasa, M.; Champika, L.; Gunathillaka, K.; Mendis, J.Schizophrenia is a progressive disorder that affects thoughts, emotions, perceptions and psychosocial behaviour.The duration of untreated psychosis (DUP) is the time period from development of initial psychotic symptom in the patient to the beginning of adequate treatment. Studies in the west have indicated that longer DUP is associated with poorer prognosis and functional levelin schizophrenia. This study aimed to quantify the DUP retrospectively in a group of patients in their first episode of schizophrenia attending the outpatient psychiatry clinic ofNational Hospital of Sri Lanka. Their functional level was assessed using the modified general assessment of functioning scale (mGAF) prospectively over three months. The mean DUP was 35.5 months and a longer DUP was significantly associated with lower mGAF scores. This DUP is higher compared to western and Indian data, and indicates the need for early recognition and management.