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Objective: Antipsychotic‐induced weight gain (AiWG) is a debilitating adverse effect of most antipsychotics. First‐episode psychosis patients are particularly vulnerable to the detrimental consequences of AiWG. Amisulpride has good efficacy and tolerability. We here aimed to identify the phenotypic factors associated with amisulpride‐induced weight gain in first‐episode psychosis patients. Method: Data were collected from the Optimization of Treatment and Management of Schizophrenia in Europe trial. Multivariable regression models with various phenotypic variables (N = 305) were performed with absolute AiWG and clinically relevant AiWG (≥7% AiWG) as outcomes. Results: Four weeks of amisulpride treatment increased body weight from 69.7 to 72.4 kg (P < 0.001). In the regression model of absolute AiWG, unemployment (β = 0.94, P = 0.016), younger age (β = −0.07, P = 0.031) and absence of current comorbid major depression disorder (β = −1.61, P = 0.034) were positively associated with absolute AiWG. In the regression model of clinically relevant AiWG, unemployment (OR = 2.83, P = 0.001), schizophreniform disorder (OR = 2.00, P = 0.025) and low baseline weight (OR = 0.97, P = 0.032) increased the likelihood of clinically relevant AiWG. Conclusions: Clinicians prescribing amisulpride should consider the relatively high susceptibility to AiWG in unemployed first‐episode patients with psychosis, in particular young subjects with a diagnosis of schizophreniform disorder. We advise to carefully monitor these patients and, when needed, implement weight‐reducing strategies. [ABSTRACT FROM AUTHOR]

Objective Schizophrenia is associated with profound cognitive and psychosocial impairments. Glucagon-like peptide-1 receptor agonists ( GLP-1 RAs) are used for diabetes and obesity treatment, and animal studies have indicated cognitive-enhancing effects. In this investigator-initiated, double-blind, randomized, placebo-controlled trial, we tested non-metabolic effects of exenatide once-weekly (Bydureon™) in obese, antipsychotic-treated patients with schizohrenia spectrum disorder. Method Before and after 3 months of exenatide ( N = 20) or placebo ( N = 20) treatment, patients were assessed with the following: Brief Assessment of Cognition in Schizophrenia ( BACS), Rey-Osterreith complex figure test ( REY), Short-Form Health Survey ( SF-36), Personal and Social Performance Scale ( PSP) and the Positive and Negative Syndrome Scale ( PANSS). We used BACS composite score as the main outcome measure. Results Repeated measures analysis of variance on BACS composite score showed significant effect of 'Time' ( P < 0.001), no effect of 'Group' ( P = 0.64) and no 'Time*Group' interaction ( P = 0.77). For REY, SF-36, PSP and PANSS, only significant 'Time' effects were found. Conclusion The non-significant results of this first clinical trial exploring non-metabolic effects of a long-acting GLP-1 RA in patients with schizophrenia could reflect a general problem of translating cognitive-enhancing effects of GLP-1 RAs from animals to humans or be explained by factors specifically related to schizophrenia spectrum patients with obesity such as antipsychotic treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND Haloperidol is frequently used to treat deliriUm in patients in the intensive care deunit (ICU), but evidence of its effect is limited. METHODS In this multicenter, blinded, placebo-controlled trial, we randomly assigned adult patients with delirium who had been admitted to the ICU for an acute condition to receive intravenous haloperidol (2.5 mg 3 times daily plus 2.5 mg as needed up to a total maximum daily dose of 20 mg) or placebo. Haloperidol or placebo was administered in the ICU for as long as delirium continued and as needed for recurrences. The primary outcome was the number of days alive and out of the hospital at 90 days after randomization. RESULTS A total of 1000 patients underwent randomization; 510 were assigned to the halo-peridol group and 490 to the placebo group. Among these patients, 987 (98.796) were included in the final analyses (501 in the haloperidol group and 486 in the placebo group). Primary outcome data were available for 963 patients (97.60). At 90 days, the mean number of days alive and out of the hospital was 35.8 (95% confidence interval ICI], 32.9 to 38.6) in the haloperidol group and 32.9 (95°6 CI, 29.9 to 35.8) in the placebo group, with an adjusted mean difference of 2.9 days (95% CI, -1.2 to ZO) (P=0.22). Mortality at 90 days was 36.3% in the haloperidol group and 43.3% in the placebo group (adjusted absolute difference, -6.9 percentage points [95% CI, -13.0 to -0.6]). Serious adverse reactions occurred in 11 patients in the haloperidol group and in 9 patients in the placebo group. CONCLUSIONS Among patients in the ICU with delirium, treatment with haloperidol did not lead to a significantly greater number of days alive and out of the hospital at 90 days than placebo. (Funded by Innovation Fund Denmark and others; AID-ICU ClinicalTrials.gov number, NCT03392376; EudraCT number, 2017-003829-15.). [ABSTRACT FROM AUTHOR]