Background: Khat contains the amphetamine-like cathinone, and can trigger onset of schizophrenia and exacerbate pre-existing psychosis. However, it remains unknown whether the use of khat complicates the outcome of schizophrenia treatment. Aims: We tested the hypothesis that patients with schizophrenia who are using khat will fail to respond to standard antipsychotic treatment. Methods: We retrospectively studied a consecutive series of patients who presented to an adult psychiatric clinic in Al-Amal Psychiatric Hospital in Jazan, Saudi Arabia, between January 1, 2013 and December 31, 2016. Patients with newly diagnosed schizophrenia on antipsychotic monotherapy (n = 1007, 817 men) were included and categorized into khat and non-khat users. A khat chewing index was developed to further categorize low, mild, moderate and heavy khat users. Antipsychotic medications were reviewed to determine their potential and the cause of substitution in association with khat use. Results: There were 483 (48%) khat users. Olanzapine, haloperidol and aripiprazole were the most frequently used drugs (46.3%, 15.6% and 10%, respectively). The retention rate of the initial drug differed between the khat users and nonusers (53.8% and 78.4%, respectively). The proportion of moderate and heavy users (55% and 49%, respectively) who changed their initial drug was greater than that of low and mild users (35.6% and 44.7%, respectively). Lack of drug efficacy was the most appealing reason for switching the initial drug among moderate (51.7%) and heavy khat users (48.4%). Conclusions: Khat use hinders an individual’s response to initial antipsychotic drug treatment for schizophrenia. Further studies are warranted to investigate the treatment decisions for this group of patients.
Field studies were conducted for two consecutive winter seasons of 2016/2017 and 2017/ 2018 to investigate the effect of mulching; (rice straw and without mulch as control) on bulbs yield, water use efficiency, plant water status and chemical composition of garlic grown under three levels of irrigation (I 100 = 100%, I 80 = 80% and I 60 = 60% of ET C crop evapotranspiration). Bulb yield, water and potassium use efficiency, plant water status (RWC), membrane stability index (MSI) and leaf N and K significantly increased by increasing irrigation levels from I 60 to I 80 and further to I 100 . I 80 was pronounced on water use efficiency and leaf P, meanwhile I 60 was pronounced on leaf total phenolic, flavonoids, anthocyanin, free proline and total free amino acids contents. Garlic plants growth was improved under three levels of irrigation by using rice straw mulch. Results implied that I 100 + rice straw, significantly, increased bulbs yield, (RWC), (MSI) and leaf N and K .In addition, I 80 + rice straw significantly, increased water use efficiency and leaf P. Howevere, I 60 + rice straw significantly, increased leaf total phenolic, flavonoids, anthocyanin, free proline and total free amino acids contents.
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