Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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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 Prevalence and correlates of cognitive impairment among patients with schizophrenia attending psychiatry outpatient clinics at Teaching hospital – Karapitiya(Sri Lanka Medical Association, 2021) Goonathilake, Y.L.A.; Ruben, R.; Ediriweera, D.S.; Isuru, L.L.A.INTRODUCTION AND OBJECTIVES: Cognitive impairment is considered a core feature of schizophrenia. This study was designed to estimate the prevalence of cognitive impairment among patients with schizophrenia, to assess the degree of impairment in individual cognitive domains and to identify its sociodemographic and clinical correlates in a Sri Lankan setting. METHODS: A sample of 140 diagnosed patients with schizophrenia was selected from the psychiatry outpatient clinics at Teaching Hospital, Karapitiya. Their cognitive functions were assessed using Addenbrooke’s Cognitive Examination – III Sinhala version (ACE-III-S). Participants who scored below 85.5 in ACE-III-S were categorized as having significant cognitive impairment. Multiple linear regression analysis was conducted to assess correlates with level of significance measured at p = 0.05. RESULTS: In this sample, 89.3% of the participants scored below ACE-III-S cut-off (95% CI [84.09,94.47]). Statistical comparison of proportions of the sample which had impairment in each cognitive domain (attention 60%, memory 65.7%, fluency 55%, language 61.4%, and visuospatial skills 63.6%) did not show a significant difference. The final model of regression analysis showed that patients with shorter duration of formal education (p = <0.001), longer duration of illness (p = <0.001) and higher dose of antipsychotics (p = 0.034) had higher cognitive impairment. CONCLUSION: Nearly nine out of ten people with schizophrenia suffer from significant cognitive dysfunction. The evaluated cognitive domains have been affected equally. The results of this study emphasize the importance of introducing routine cognitive assessment protocols, improving facilities available for cognitive rehabilitation and more frequent review of antipsychotic medications.