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Despite extensive clinical concern about rates of obesity in patients
with schizophrenia, there is little evidence of the extent of this
problem at a population level.
To estimate levels of obesity in a national population sample by
comparing patients with schizophrenia with matched controls.
We calculated levels of obesity for each patient with schizophrenia from
the national Primary Care Clinical Informatics Unit database (n=4658)
matched with age, gender and neighbourhood controls.
We demonstrated a significant increased obesity hazard for the
schizophrenia group using Cox regression analysis, with odds ratio (OR)
of 1.94 (95% CI 1.81–2.10) (under the assumption of missing body mass
index (BMI) indicating non-obesity) and OR=1.68 (95% CI 1.55–1.81) where
no assumptions were made for missing BMI data.
People with schizophrenia are at increased risk of being obese compared
with controls matched by age, gender and practice attended. Priority
should be given to research which aims to reduce weight and increase
activity in those with schizophrenia.
Ketamine has recently become an agent of interest as an acute treatment for severe depression and as the anaesthetic for electroconvulsive therapy (ECT). Subanaesthetic doses result in an acute reduction in depression severity while evidence is equivocal for this antidepressant effect with anaesthetic or adjuvant doses. Recent systematic reviews call for high-quality evidence from further randomised controlled trials (RCTs).
To establish if ketamine as the anaesthetic for ECT results in fewer ECT treatments, improvements in depression severity ratings and less memory impairment than the standard anaesthetic.
Double-blind, parallel-design, RCT of intravenous ketamine (up to 2 mg/kg) with an active comparator, intravenous propofol (up to 2.5 mg/kg), as the anaesthetic for ECT in patients receiving ECT for major depression on an informal basis. (Trial registration: European Clinical Trials Database (EudraCT): 2011-000396-14 and clinicalTrials.gov: NCT01306760.)
No significant differences were found on any outcome measure during, at the end of or 1 month following the ECT course.
Ketamine as an anaesthetic does not enhance the efficacy of ECT.
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