Treatment of methamphetamine-induced psychosis: a double-blind randomized controlled trial comparing haloperidol and quetiapine

Rationale

To our knowledge, only a few double-blind randomized controlled trials with antipsychotic drugs have been conducted to examine the treatment of methamphetamine-induced psychosis (MAP).

Objectives

The aims of this study are to compare the antipsychotic and adverse events of quetiapine, an atypical antipsychotic drug, to haloperidol, a standard treatment for primary psychotic disorder, in individuals with MAP.

Methods

Eighty individuals with MAP were randomly assigned into two groups, i.e. treatment with quetiapine (n?=?36) and haloperidol (n?=?44). Sixty-eight patients (85 %) completed the study protocol, i.e. treatment with quetiapine at least 100 mg per day or haloperidol at least 2 mg per day orally once a day for 4 weeks. The doses were increased every 5 days until no psychotic symptom was observed from the Positive and Negative Syndrome Scale (PANSS). Data were analysed by survival analysis with Cox’s proportional regression analysis, general estimating equations and log-rank tests.

Results

Thirty-two (89 %) subjects from the quetiapine group and 37 subjects (84 %) from the haloperidol group met the remission criteria at the end of the study. Baseline PANSS total scores of quetiapine and haloperidol groups were 82.4?±?16.6 and 90.0?±?18.4, respectively (mean?±?SD; p?=?0.06). The change-from-baseline scores were ?47.8 for the quetiapine group and ?53.2 for the haloperidol group. There were no significant differences between the antipsychotic effects (coefficient value?=??2.6, p?=?0.32, 95%CI?=??7.6, 2.5) and the adverse effects of quetiapine and haloperidol.

Conclusions

Quetiapine may be used as an antipsychotic treatment for MAP with comparable therapeutic effects and adverse events to treatment with classical antipsychotic drugs.     

Factors associated with obesity among workers in a metropolitan waterworks authority

To examine the relationship of socio-demographic characteristics, psychological factors, knowledge, attitude and behavior towards obesity among Metropolitan Waterworks Authority (MWWA) officers, a cross-sectional study was conducted between July and September, 2004. Two hundred and eighty-eight obese [body mass index (BMI) > or = 25 kg/m2] and 106 non-obese persons, aged 20-60 years, were recruited as study subjects. Data were collected by a self-administered questionnaire, comprised of three parts: socio-demographic; psychological factors (depression and stress); and knowledge, attitude, behavior related to obesity. Univariate analyses and Logistic regression models were used to study the association between obesity and possible risk factors. The results demonstrate significant associations between older age and obesity. Volunteers in the age groups of 40-49 and 50-59 years had a significantly higher risk of being obese than the age group of less than 40 years (adjusted OR = 3.4, 95% Cl = 1.1-11.1 and adjusted OR = 10.4, 95% CI = 3.3-32.7, respectively). Volunteers with unhealthy behaviors were at significantly higher risk than those with healthy behaviors (adjusted OR = 10.3, 95% CI = 2.0-52.4) while persons with moderately healthy behaviors also had increased risk, but to a lesser extent (adjusted OR = 4.5, 95% CI = 1.7-11.4). There were no associations between psychological factors and obesity in this group of volunteers. When we focused on whether they consumed more food when they were stressed, it was found that the obese consumed significantly more food during stress (p-value = 0.003). Watching television, videos, or playing computer continuously for more than 3 hours, were significantly associated with obesity. We conclude that although the obese have a good knowledge and attitude towards obesity, they still practise unhealthy behavior, have a sedentary lifestyle, and over eat when they are stressed. Future research regarding behavioral modification should be implemented at both community and country levels.