OBJECTIVES: Amisulpride in antipsychotic doses can induce hyperprolactinemia. The aim of this stu... more OBJECTIVES: Amisulpride in antipsychotic doses can induce hyperprolactinemia. The aim of this study was to prove whether the same is true for low doses of amisulpride. METHODOLOGY: Plasma prolactin levels were measured in 5 males and 5 females with depressive symptoms who were treated with 50 mg of amisulpride per day as an augmentation to antidepressants (n=5), benzodiazepine anxiolytics (n=8) or in monotherapy (n=1). Six of these patients were assessed prior to onset of amisulpride treatment and after 10 days of amisulpride use. Four patients had been using amisulpride for more than a month. RESULTS: There was a significant increase of prolactin levels from mean 16±6 ng/ml to 113±65 ng/ml (median 14.5 ng/ml to median 92 ng/ml; Wilcoxon matched pair test, p=0.027). All patients had hyperprolactinemia (30–200 ng/ ml). The prolactinemia was significantly higher in females (mean 160±50 ng/ml; median 198 ng/ml) than in males (mean 48±12 ng/ml; median 48 ng/ml; MannWhitney U test, p=0.0...
OBJECTIVES Our aim was to examine the effect of vitamin D deficiency on BMI in patients treated w... more OBJECTIVES Our aim was to examine the effect of vitamin D deficiency on BMI in patients treated with Multi-acting Receptor Target Antipsychotics (MARTA). METHODS We measured serum 25-hydroxyvitamin D [25(OH)D] levels and body mass index (BMI) in patients with (≥1 months) and without long-term exposure to MARTA to evaluate the role of 25(OH)D deficiency on BMI. RESULTS The BMI was significantly higher after long-term MARTA exposure in 25(OH)D-deficient patients than in non-deficient patients. No significant difference was found in antipsychotic exposure between the long-term MARTA exposure groups. The BMI was significantly higher in long-term MARTA exposure 25(OH)D-deficient patients than in 25(OH)D-deficient patients without long-term exposure. CONCLUSION Vitamin D deficiency could be a risk factor for MARTA-induced weight gain. Further studies are necessary to replicate this finding.
Medicina založena na důkazech potvrdila, že antidepresiva jsou ucinna v lecbě deprese, ale dodnes... more Medicina založena na důkazech potvrdila, že antidepresiva jsou ucinna v lecbě deprese, ale dodnes neni zřejme, jake antidepresivum bude nejlepsi pro ktereho pacienta. Výsledky EEG studii ukazuji, že po jednom týdnu lecby antidepresivem můžeme spravně předpovědět, že 8 z 10 pacientů nedosahne odpovědi na lecbu, pokud bude ve stejne lecbě antidepresivem pokracovano dalsich 3–7 týdnů. EEG může pomoci ve volbě spravneho antidepresiva obdobně jako mikrobiologicke vysetřeni pomaha zvolit spravne antibiotikum.
BACKGROUND: Schizophrenia and bipolar disorder share genetic liability, and some structural brain... more BACKGROUND: Schizophrenia and bipolar disorder share genetic liability, and some structural brain abnormalities are common to both conditions. First-degree relatives of patients with schizophrenia (FDRs-SZ) show similar brain abnormalities to patients, albeit with smaller effect sizes. Imaging findings in first-degree relatives of patients with bipolar disorder (FDRs-BD) have been inconsistent in the past, but recent studies report regionally greater volumes compared with control subjects. METHODS:Weperformedameta-analysis of global andsubcortical brainmeasuresof 6008 individuals (1228FDRs-SZ, 852 FDRs-BD, 2246 control subjects, 1016 patients with schizophrenia, 666 patients with bipolar disorder) from 34 schizophrenia and/or bipolar disorder family cohorts with standardized methods. Analyses were repeated with a correction for intracranial volume (ICV) and for thepresenceof anypsychopathology in the relatives andcontrol subjects. RESULTS: FDRs-BD had significantly larger ICV (d = 1...
Antipsychotika jsou leciva, ktera se uživaji předevsim v lecbě schizofrenie, psychoz, agresivity ... more Antipsychotika jsou leciva, ktera se uživaji předevsim v lecbě schizofrenie, psychoz, agresivity a neklidu. Některa antipsychotika druhe generace potvrdila svoji ucinnost v udržovaci i akutni lecbě manicke a depresivni faze bipolarni afektivni poruchy, v monoterapii unipolarni deprese ci jako augmentacni strategie k lecbě antidepresivy u pacientů s uzkostnými a depresivnimi poruchami. Při použiti antipsychotik u seniorů musime zvažovat efektivitu a rizika lecby antipsychotiky.
ResumenPropósito.La disminución del volumen del hipocampo comunicada en trastornos neuropsiquiátr... more ResumenPropósito.La disminución del volumen del hipocampo comunicada en trastornos neuropsiquiátricos y endocrinos se considera resultado de un daño neuronal putativo mediado por corticoesteroides. Éste es el primer estudio prospectivo del volumen y la función del hipocampo en pacientes tratados con corticoesteroides.Métodos.Se sometió a 14 sujetos tratados sistémicamente con prednisona o betametasona por trastornos dermatológicos o reumáticos a pruebas neurocognitivas prospectivas (Prueba de Aprendizaje Verbal Auditivo [AVLT], Prueba del Trazo [TMT], Amplitud de dígitos [AD]) y nueve de ellos repitieron también una volumetría de resonancia magnética.Resultados.La duración media del tratamiento entre la primera evaluación y la segunda fue 73 ± 38 días con dosis diaria media de 37 ± 17 mg de prednisona y 193 ± 29 días, con dosis diaria media de 24 ± 15 mg de prednisona, entre la primera evaluación y la tercera. Hubo una tendencia a disminuciones en las puntuaciones totales de la AVLT...
Studies from North America and Western Europe suggest stable or declining trends in impaired cogn... more Studies from North America and Western Europe suggest stable or declining trends in impaired cognition. Nevertheless, data on changes in cognitive health from Central and Eastern Europe are largely lacking. Therefore, we aimed to examine changes in the age-specific prevalence of cognitive impairment in the Czech Republic, a country in Central Europe. To this aim we used two samples from the population-based Czech Survey on Health, Ageing and Retirement in Europe (SHARE). Age-specific prevalence of cognitive impairment (defined based on scores in verbal fluency, immediate recall, delayed recall and temporal orientation) was compared between participants in wave 2 (2006/2007; n=1,107) and wave 6 (2015; n=3,104). Logistic regression was used to estimate the association between wave and cognitive impairment, step-wise adjusting for sociodemographic and clinical characteristics. Multiple sensitivity analyses, focusing on alternative operationalisations of relative cognitive impairment, i...
Česká a slovenská neurologie a neurochirurgie, 2015
ABSTRACT Aim: The aim of the study was to report normative data on letter (LF; letters K, P, S) a... more ABSTRACT Aim: The aim of the study was to report normative data on letter (LF; letters K, P, S) and semantic fl uency (SF; animals and vegetables). Introduction: Verbal fl uency (VF) is one of the most frequently used neuropsychological methods for the assessment of cognitive performance in clinical and experimental neuropsychology. However, representative normative data for the Czech population of older and very old adults are so far lacking. Methods: We administered VF as part of neuropsychological battery to 540 (292 women, 248 men) healthy older adults (60– 96 years of age). In LF, the letters K, P, S and their total score were used as analogous to the original Controlled Oral Word Association Test (COWAT/ FAS). In SF, we evaluated performance in two categories – animals and vegetables. Results: Age was signifi cantly (p < 0.001) related to a sum of K + P + S (r = – 0.236) as well as animals (r = – 0.359) and vegetables (r = – 0.264). However, the association was moderate. Education was also moderately related (p < 0.001) to the sum of K + P + S (r = 0.297) and animals (r = 0.357). However, we did not fi nd a signifi cant relationship between age and vegetables (r = 0.028; p = 0.523). Vegetables were also the only measure that showed highly signifi cant sex diff erences (p < 0.001). We present normative Czech data for 60– 75, 70– 85 and 80– 96 age groups. Conclusion: The results of our study confi rm a signifi - cant moderate infl uence of age and education (with the exception of vegetables for the latter) on all VF measures. There were highly signifi cant sex diff erences in the vegetable category.
The high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) over the prefrontal cor... more The high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) over the prefrontal cortex is a promising method for the treatment of negative symptoms of schizophrenia. Using double-blind sham-controlled parallel design, we evaluated the effect of HF-rTMS over the left dorsolateral prefrontal cortex (DLPFC) on negative symptoms in patients with schizophrenia. Sixteen schizophrenia patients with predominantly negative symptoms on stable antipsychotic medication were treated with 20 Hz rTMS (90% of motor threshold, 2000 stimuli per session) over ten days within 2 weeks with six weeks follow-up. The effect was assessed using PANSS, CGI, MADRS and neuropsychological tests. We failed to find any significant effect of active rTMS. Sham rTMS showed a trend for improvement over time on positive and negative subscales of PANSS and MADRS. Between-group comparisons failed to reveal any significant differences on any rating scales except a positive subscale of PANSS after 8 weeks. Re...
Risperidone in antipsychotic doses induces hyperprolactinemia. The aim of this study was to verif... more Risperidone in antipsychotic doses induces hyperprolactinemia. The aim of this study was to verify whether the same is true for low doses of risperidone (0.5-2 mg per day) added to antidepressants or anxiolytics. Prolactin levels were measured in 4 men (mean age 49.5+/-19.1 years) and 8 women (mean age 31.3+/-8.2 years) inpatients with depressive and anxiety disorders who were treated with risperidone (median doses per day 1.25 mg) for median 15.5 days as an augmentation treatment to antidepressants (n=8), anxiolytics (n=6) and mood stabilizers (n=2). 11 of 12 patients had hyperprolactinemia. Median plasma prolactin level was 1598 mIU/ml, 95% CI 1 040-2 661 mIU/ml. Significant correlation between risperidone daily dose and plasma prolactin level (Spearman's R=0.655, p=0.02) was detected. Two women suffered from galactorrhea and one from amenorrhea. Even low doses of risperidone used as an augmentation to antidepressants or benzodiazepines are associated with hyperprolactinemia a...
The aim of our study was to detect changes in the distribution of electrical brain activity in sc... more The aim of our study was to detect changes in the distribution of electrical brain activity in schizophrenic patients who were antipsychotic naive and those who received treatment with clozapine, olanzapine or risperidone. We included 41 subjects with schizophrenia (antipsychotic naive = 11; clozapine = 8; olanzapine = 10; risperidone = 12) and 20 healthy controls. Low-resolution brain electromagnetic tomography was computed from 19-channel electroencephalography for the frequency bands delta, theta, alpha-1, alpha-2, beta-1, beta-2 and beta-3. We compared antipsychotic-naive subjects with healthy controls and medicated patients. (1) Comparing antipsychotic-naive subjects and controls we found a general increase in the slow delta and theta frequencies over the fronto-temporo-occipital cortex, particularly in the temporolimbic structures, an increase in alpha-1 and alpha-2 in the temporal cortex and an increase in beta-1 and beta-2 in the temporo-occipital and posterior limbic struct...
OBJECTIVES: Amisulpride in antipsychotic doses can induce hyperprolactinemia. The aim of this stu... more OBJECTIVES: Amisulpride in antipsychotic doses can induce hyperprolactinemia. The aim of this study was to prove whether the same is true for low doses of amisulpride. METHODOLOGY: Plasma prolactin levels were measured in 5 males and 5 females with depressive symptoms who were treated with 50 mg of amisulpride per day as an augmentation to antidepressants (n=5), benzodiazepine anxiolytics (n=8) or in monotherapy (n=1). Six of these patients were assessed prior to onset of amisulpride treatment and after 10 days of amisulpride use. Four patients had been using amisulpride for more than a month. RESULTS: There was a significant increase of prolactin levels from mean 16±6 ng/ml to 113±65 ng/ml (median 14.5 ng/ml to median 92 ng/ml; Wilcoxon matched pair test, p=0.027). All patients had hyperprolactinemia (30–200 ng/ ml). The prolactinemia was significantly higher in females (mean 160±50 ng/ml; median 198 ng/ml) than in males (mean 48±12 ng/ml; median 48 ng/ml; MannWhitney U test, p=0.0...
OBJECTIVES Our aim was to examine the effect of vitamin D deficiency on BMI in patients treated w... more OBJECTIVES Our aim was to examine the effect of vitamin D deficiency on BMI in patients treated with Multi-acting Receptor Target Antipsychotics (MARTA). METHODS We measured serum 25-hydroxyvitamin D [25(OH)D] levels and body mass index (BMI) in patients with (≥1 months) and without long-term exposure to MARTA to evaluate the role of 25(OH)D deficiency on BMI. RESULTS The BMI was significantly higher after long-term MARTA exposure in 25(OH)D-deficient patients than in non-deficient patients. No significant difference was found in antipsychotic exposure between the long-term MARTA exposure groups. The BMI was significantly higher in long-term MARTA exposure 25(OH)D-deficient patients than in 25(OH)D-deficient patients without long-term exposure. CONCLUSION Vitamin D deficiency could be a risk factor for MARTA-induced weight gain. Further studies are necessary to replicate this finding.
Medicina založena na důkazech potvrdila, že antidepresiva jsou ucinna v lecbě deprese, ale dodnes... more Medicina založena na důkazech potvrdila, že antidepresiva jsou ucinna v lecbě deprese, ale dodnes neni zřejme, jake antidepresivum bude nejlepsi pro ktereho pacienta. Výsledky EEG studii ukazuji, že po jednom týdnu lecby antidepresivem můžeme spravně předpovědět, že 8 z 10 pacientů nedosahne odpovědi na lecbu, pokud bude ve stejne lecbě antidepresivem pokracovano dalsich 3–7 týdnů. EEG může pomoci ve volbě spravneho antidepresiva obdobně jako mikrobiologicke vysetřeni pomaha zvolit spravne antibiotikum.
BACKGROUND: Schizophrenia and bipolar disorder share genetic liability, and some structural brain... more BACKGROUND: Schizophrenia and bipolar disorder share genetic liability, and some structural brain abnormalities are common to both conditions. First-degree relatives of patients with schizophrenia (FDRs-SZ) show similar brain abnormalities to patients, albeit with smaller effect sizes. Imaging findings in first-degree relatives of patients with bipolar disorder (FDRs-BD) have been inconsistent in the past, but recent studies report regionally greater volumes compared with control subjects. METHODS:Weperformedameta-analysis of global andsubcortical brainmeasuresof 6008 individuals (1228FDRs-SZ, 852 FDRs-BD, 2246 control subjects, 1016 patients with schizophrenia, 666 patients with bipolar disorder) from 34 schizophrenia and/or bipolar disorder family cohorts with standardized methods. Analyses were repeated with a correction for intracranial volume (ICV) and for thepresenceof anypsychopathology in the relatives andcontrol subjects. RESULTS: FDRs-BD had significantly larger ICV (d = 1...
Antipsychotika jsou leciva, ktera se uživaji předevsim v lecbě schizofrenie, psychoz, agresivity ... more Antipsychotika jsou leciva, ktera se uživaji předevsim v lecbě schizofrenie, psychoz, agresivity a neklidu. Některa antipsychotika druhe generace potvrdila svoji ucinnost v udržovaci i akutni lecbě manicke a depresivni faze bipolarni afektivni poruchy, v monoterapii unipolarni deprese ci jako augmentacni strategie k lecbě antidepresivy u pacientů s uzkostnými a depresivnimi poruchami. Při použiti antipsychotik u seniorů musime zvažovat efektivitu a rizika lecby antipsychotiky.
ResumenPropósito.La disminución del volumen del hipocampo comunicada en trastornos neuropsiquiátr... more ResumenPropósito.La disminución del volumen del hipocampo comunicada en trastornos neuropsiquiátricos y endocrinos se considera resultado de un daño neuronal putativo mediado por corticoesteroides. Éste es el primer estudio prospectivo del volumen y la función del hipocampo en pacientes tratados con corticoesteroides.Métodos.Se sometió a 14 sujetos tratados sistémicamente con prednisona o betametasona por trastornos dermatológicos o reumáticos a pruebas neurocognitivas prospectivas (Prueba de Aprendizaje Verbal Auditivo [AVLT], Prueba del Trazo [TMT], Amplitud de dígitos [AD]) y nueve de ellos repitieron también una volumetría de resonancia magnética.Resultados.La duración media del tratamiento entre la primera evaluación y la segunda fue 73 ± 38 días con dosis diaria media de 37 ± 17 mg de prednisona y 193 ± 29 días, con dosis diaria media de 24 ± 15 mg de prednisona, entre la primera evaluación y la tercera. Hubo una tendencia a disminuciones en las puntuaciones totales de la AVLT...
Studies from North America and Western Europe suggest stable or declining trends in impaired cogn... more Studies from North America and Western Europe suggest stable or declining trends in impaired cognition. Nevertheless, data on changes in cognitive health from Central and Eastern Europe are largely lacking. Therefore, we aimed to examine changes in the age-specific prevalence of cognitive impairment in the Czech Republic, a country in Central Europe. To this aim we used two samples from the population-based Czech Survey on Health, Ageing and Retirement in Europe (SHARE). Age-specific prevalence of cognitive impairment (defined based on scores in verbal fluency, immediate recall, delayed recall and temporal orientation) was compared between participants in wave 2 (2006/2007; n=1,107) and wave 6 (2015; n=3,104). Logistic regression was used to estimate the association between wave and cognitive impairment, step-wise adjusting for sociodemographic and clinical characteristics. Multiple sensitivity analyses, focusing on alternative operationalisations of relative cognitive impairment, i...
Česká a slovenská neurologie a neurochirurgie, 2015
ABSTRACT Aim: The aim of the study was to report normative data on letter (LF; letters K, P, S) a... more ABSTRACT Aim: The aim of the study was to report normative data on letter (LF; letters K, P, S) and semantic fl uency (SF; animals and vegetables). Introduction: Verbal fl uency (VF) is one of the most frequently used neuropsychological methods for the assessment of cognitive performance in clinical and experimental neuropsychology. However, representative normative data for the Czech population of older and very old adults are so far lacking. Methods: We administered VF as part of neuropsychological battery to 540 (292 women, 248 men) healthy older adults (60– 96 years of age). In LF, the letters K, P, S and their total score were used as analogous to the original Controlled Oral Word Association Test (COWAT/ FAS). In SF, we evaluated performance in two categories – animals and vegetables. Results: Age was signifi cantly (p < 0.001) related to a sum of K + P + S (r = – 0.236) as well as animals (r = – 0.359) and vegetables (r = – 0.264). However, the association was moderate. Education was also moderately related (p < 0.001) to the sum of K + P + S (r = 0.297) and animals (r = 0.357). However, we did not fi nd a signifi cant relationship between age and vegetables (r = 0.028; p = 0.523). Vegetables were also the only measure that showed highly signifi cant sex diff erences (p < 0.001). We present normative Czech data for 60– 75, 70– 85 and 80– 96 age groups. Conclusion: The results of our study confi rm a signifi - cant moderate infl uence of age and education (with the exception of vegetables for the latter) on all VF measures. There were highly signifi cant sex diff erences in the vegetable category.
The high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) over the prefrontal cor... more The high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) over the prefrontal cortex is a promising method for the treatment of negative symptoms of schizophrenia. Using double-blind sham-controlled parallel design, we evaluated the effect of HF-rTMS over the left dorsolateral prefrontal cortex (DLPFC) on negative symptoms in patients with schizophrenia. Sixteen schizophrenia patients with predominantly negative symptoms on stable antipsychotic medication were treated with 20 Hz rTMS (90% of motor threshold, 2000 stimuli per session) over ten days within 2 weeks with six weeks follow-up. The effect was assessed using PANSS, CGI, MADRS and neuropsychological tests. We failed to find any significant effect of active rTMS. Sham rTMS showed a trend for improvement over time on positive and negative subscales of PANSS and MADRS. Between-group comparisons failed to reveal any significant differences on any rating scales except a positive subscale of PANSS after 8 weeks. Re...
Risperidone in antipsychotic doses induces hyperprolactinemia. The aim of this study was to verif... more Risperidone in antipsychotic doses induces hyperprolactinemia. The aim of this study was to verify whether the same is true for low doses of risperidone (0.5-2 mg per day) added to antidepressants or anxiolytics. Prolactin levels were measured in 4 men (mean age 49.5+/-19.1 years) and 8 women (mean age 31.3+/-8.2 years) inpatients with depressive and anxiety disorders who were treated with risperidone (median doses per day 1.25 mg) for median 15.5 days as an augmentation treatment to antidepressants (n=8), anxiolytics (n=6) and mood stabilizers (n=2). 11 of 12 patients had hyperprolactinemia. Median plasma prolactin level was 1598 mIU/ml, 95% CI 1 040-2 661 mIU/ml. Significant correlation between risperidone daily dose and plasma prolactin level (Spearman's R=0.655, p=0.02) was detected. Two women suffered from galactorrhea and one from amenorrhea. Even low doses of risperidone used as an augmentation to antidepressants or benzodiazepines are associated with hyperprolactinemia a...
The aim of our study was to detect changes in the distribution of electrical brain activity in sc... more The aim of our study was to detect changes in the distribution of electrical brain activity in schizophrenic patients who were antipsychotic naive and those who received treatment with clozapine, olanzapine or risperidone. We included 41 subjects with schizophrenia (antipsychotic naive = 11; clozapine = 8; olanzapine = 10; risperidone = 12) and 20 healthy controls. Low-resolution brain electromagnetic tomography was computed from 19-channel electroencephalography for the frequency bands delta, theta, alpha-1, alpha-2, beta-1, beta-2 and beta-3. We compared antipsychotic-naive subjects with healthy controls and medicated patients. (1) Comparing antipsychotic-naive subjects and controls we found a general increase in the slow delta and theta frequencies over the fronto-temporo-occipital cortex, particularly in the temporolimbic structures, an increase in alpha-1 and alpha-2 in the temporal cortex and an increase in beta-1 and beta-2 in the temporo-occipital and posterior limbic struct...
Uploads
Papers by Miloslav Kopecek