T210. REVIEW OF USE OF ADJUNCTIVE PSYCHOSTIMULANTS IN PATIENTS WITH SCHIZOPHRENIA: A RETROSPECTIVE STUDY
Bibliographic record
Abstract
Abstract Background Augmentation with psychostimulants has been postulated as one of the potential treatment options for negative and/or cognitive symptoms of schizophrenia. However, the major drawback for use of these agents is a potential risk of relapse or worsening of psychosis through direct or indirect dopamine agonism activity. Therefore a great deal of caution is required when using stimulants in individuals with psychosis. The present study aims to review the rate of adjunct psychostimulant prescription, and their efficacy and safety in a real life setting. Furthermore, we intend to compare the efficacy of psychostimulants when added to clozapine compared to other antipsychotics. Data was obtained from a schizophrenia outpatient clinic, in a tertiary care centre in Canada. Methods A chart review was conducted on outpatients enrolled in the schizophrenia program at the Royal Ottawa Mental Health Centre, between 31/5/2014 - 1/6/2019. For patients who were prescribed any psychostimulants at any time point up to 3-months prior to the study end date, clinical information related to efficacy and tolerability of stimulants, psychotic symptoms and concomitant antipsychotic treatment was collected. Results A total number of 1300 patients were included in the chart review study. Of those, 80 patients (6.15%) were prescribed stimulants during the study period. Of the participants who prescribed stimulants, 70% were male, 17.5% had a diagnosis of ADHD, and 38.75% were on clozapine. 21.25% had more than one trial of stimulant medications. Over half of participants continued on stimulants during the study period, with an overall good response in 36.25%, and minimal or equivocal response in 20% of participants on stimulants. Stimulants were discontinued in 13.75% of patients due to lack of efficacy, and 30% due to problematic symptoms. The data is currently being analysed; Comprehensive results to follow. Discussion The preliminary results indicate that the use of stimulants was associated with improvement in cognitive and/or negative symptoms in a subset of patients and resulted in worsening of psychosis in some patients. The authors will discuss the efficacy and tolerability of use of adjunctive stimulants in outpatients with schizophrenia. Potential factors associated with the observed response and side effects will be discussed further.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.008 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".