Background: Hyponatremia (HN; serum sodium concentration [Na+] < 136 mEq/L) is a prevalent and potentially life-threatening condition often seen in psychotic patients. Recent studies of healthy controls have shown that even mild-to-moderate HN, once thought a benign condition, are actually associated with deficits in balance and reaction time. These deficits have been linked to increased risk of falls and broken bones. The primary objective of this study was to compare simple reaction time (SRT) measures among 3 groups: healthy controls (HCs), psychotic individuals without HN (SZC), and psychotic individuals with HN (SZHN). Methods: The 3 groups (N = 20 each) were recruited from inpatients and staff at 2 long-term state psychiatric hospitals. Group mean ages for HCs, SZCs, and SZHNs were 50.5, 49.2, and 49.3 years, respectively. Groups were matched for gender and age (+2 years). SRTs were measured using the Deary-Liewald reaction time task. Results: Group mean [Na+] for HCs, SZCs, and SZHNs were 141.0, 140.3, and 129.1 mEq/L, respectively. Group mean SRTs (SE) were 300.5 (7.7), 442.6 (32.1), and 571.3 (37.1) milliseconds, respectively. Analysis (3-way analysis of variance) of GROUP mean SRTs yielded a statistically significant main effect for GROUP: f-ratio = 16.75, P < .0005. All 2-way comparisons yielded statistically significant differences: P < .01 (HCs < SZCs < SZHNs). Conclusion: Studies of simple reaction time have consistently shown that psychotic populations have prolonged reaction times when compared to healthy controls. This is one of the most ubiquitous findings in the schizophrenia literature. While results from this study replicate this well-established observation, the important finding here is that mild-to-moderate HN worsens the already impaired reaction time performance in psychotic patients. Worsening reaction time in psychotic patients may help to explain why mild to moderate HN is associated with an increased risk of falls in this population. Background: Clozapine is the most effective antipsychotic for treatment refractory schizophrenia but causes significant metabolic disturbances including obesity and type 2 diabetes. The metabolic adverse reactions may be mediated in part by clozapine-induced dysregulation of glucagonlike-peptide-1 (GLP-1). GLP-1 is an intestinal epithelial-derived peptide, released with ingestion of food, that triggers satiety, reduces glucagon production, promotes insulin production, and slows gut motility. Clozapine has been shown to interfere with GLP-1 function in animal models, leading to metabolic dysregulation including obesity and preference for high-calorie meals. Administration to animals of exogenous GLP-1 agonists such as exenatide have been shown to counter this effect of clozapine. Exenatide subcutaneous weekly injections may assist obese people on clozapine to lose weight. Methods: This randomized, controlled, open-label, pilot trial aims to evaluate the effect of exenatide on weight loss among clozapine-treated obese adults who have schizophrenia, with o...
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