The conference participants recommended that mental health care providers perform physical health monitoring that typically occurs in primary care settings for their patients who do not receive physical health monitoring in those settings. This change in usual practice is recommended on the basis of the conference participants' belief that this additional monitoring will result in the earlier detection of common, serious risk factors that could, without detection and intervention, contribute to impaired health of patients with schizophrenia.

Most research literature concerning pharmacological treatments reports results from controlled clinical trials, which provide data critical to assess the efficacy of new treatments in research populations. Fewer studies examine how treatments are adopted in everyday practice settings, where comorbid disorders and environmental issues typically complicate patients' situations. In this study, we examine the evolution of antipsychotic prescribing practices in the New York region of the Veterans Healthcare Administration (VHA) from 1998 to 2000 using administrative data. Second generation antipsychotic medications are now prescribed more frequently than the older antipsychotic medications, with a concomitant increase in cost. Data show low rates of clozapine use, relatively high rates of polypharmacy, and intersite variation in prescribing practices. Additional research in everyday practice settings is needed to address clinical questions unlikely to be answered through traditional efficacy research and to examine reasons for intersite differences in prescribing patterns.

The 8-fold increase in duration of wound analgesia and the lower plasma levels seen with the liposomal formulation are explained by gradual drug release from the liposomal depot. These results may have important implications for achieving safe and effective analgesia with wound infiltration techniques in humans.

Few studies have examined gender differences in the propensity to gain weight on clozapine. Weight gain increases risk for many medical illnesses and is of particular concern for people with schizophrenia who are more overweight than the general population. Long-stay patients in Connecticut state hospitals were randomly assigned to switch to open-label treatment with clozapine (n = 138) or to continue receiving first generation (conventional) antipsychotic medications (n = 89). Using survival and random regression models, we examined percentage of body weight gained during 2 years for patients assigned to clozapine versus those who continued taking first generation antipsychotic medications. We also examined the impact of gender on weight gain. Patients who switched to clozapine gained a greater percentage of weight (13 pounds, 7%) than did patients remaining on first generation medications (5 pounds, 4%) at the end of 2 years. Normal-weight patients on clozapine were more likely to become obese (body mass index [BMI] > or = 30). Patients gained weight whether they switched to clozapine or remained on first generation antipsychotic medications, but weight gain was significantly greater (1 BMI unit) in the clozapine-treated group, particularly among women.