Bonga Chiliza

Incidence of anxiety and depression in a predominantly HIV-infected population with severe adverse drug reactions

CITATION: Zitha, E., Chiliza, B., Muloiwa, R. & Lehloenya, R. 2014. Incidence of anxiety and depression in a predominantly HIV-infected population with severe adverse drug reactions. Clinical and Translational Allergy, 4(Suppl 3):P95, doi:10.1186/2045-7022-4-S3-P95.

S100. EFFECTS OF CANNABIS USE ON BODY MASS, FASTING GLUCOSE AND LIPIDS DURING THE FIRST 12 MONTHS OF TREATMENT IN SCHIZOPHRENIA SPECTRUM DISORDERS

Abstract Background Acute cannabis use stimulates appetite, while general population studies suggest that chronic use is associated with reduced risk of obesity and other cardiometabolic risk factors. Methods In this study, we investigated changes in body mass index (BMI), fasting blood glucose and lipids, and rates of metabolic syndrome risk factors in cannabis users vs. non-users in 109 minimally treated patients with first-episode schizophrenia, schizophreniform or schizo-affective disorder who were treated according to a standardized treatment regime with depot antipsychotic medication over 12 months. Participants underwent repeated urine toxicology tests for cannabis and those testing positive at any time during the study (n=40), were compared with those who tested negative at all time points (n=69). Results There was a significant group*time interaction effect (p=0.002) with the cannabis negative group showing a greater increase in BMI than the cannabis positive group, after adjusting for age, sex, methamphetamine use and modal dose of antipsychotic. There were no group*time interaction effects for fasting blood glucose or lipids. Post hoc tests indicated significant increases in fasting blood glucose and triglycerides and a decrease in high-density lipoprotein cholesterol for the cannabis negative group, with no significant changes in the cannabis positive group. Rates of metabolic syndrome did not differ significantly between groups. However, more cannabis negative patients had elevated waist-circumference at endpoint (p=0.003). Discussion Although other indirect effects such as dietary neglect and smoking may be contributory and could explain our findings, it may be that chronic cannabis use directly suppresses appetite, thereby preventing weight gain in users.

Neurological Soft Signs, Spontaneous and Treatment Emergent Extrapyramidal Syndromes in Black Africans With First Episode Schizophrenia

Background: Very little is known about the relationship between spontaneous and treatment-induced motor syndromes in Africans with first episode schizophrenia. Objective: We investigated the association between spontaneous NSS and EPS, with treatment-induced EPS in a homogenous sample of Black Africans with first episode schizophrenia. Methods: We examined Xhosa (South Africa) and Yoruba (Nigeria) patients, using the Neurological Evaluation Scale and extrapyramidal symptoms scale before and at 3 months after exposure to low dose flupenthixol decanoate. Pearsons correlations and Linear regression models, controlling for duration of untreated psychosis (D.U.P) and premorbid adjustments, were used in examining associations. Results: Among 99 participants in the baseline sample, 91 (91.8%) and 20 (20.2%) had at least one definite NSS and EPS, respectively, before exposure to antipsychotics. Treatment-induced EPS were recorded in 34 (38.6%). Spontaneous EPS was associated with treatment-emergent Akathisia in participants with a longer D.U.P (r = 0.75, β = 0.70, p = 0.008). This association was specific for Parkinsonism (r = 0.75, β = 0.85, p = 0.008) and dyskinesia (r = 0.75, β = 1.70, p = 0.008). Conclusion: Similar to previous findings for tardive dyskinesia in studies implementing longer-term follow-up, spontaneous EPS may also predict short-term antipsychotic-induced EPS such as akathisia. These results may be important for early identification of patients at risk of treatment-induced Akathisia-linked psychomotor agitation in first episode schizophrenia.