اطلاعات تماس با دکتر جمشید دونلو متخصص مغز و اعصاب نشاني ۱:تهران - ميدان فاطمي ( جهاد ) بيمارستان سجاد(صبح روزهای فرد)- تلفن ۶-۸۸۹۵۷۳۹۱ نشاني ٢ : تهران - بزرگراه جلال آل احمد- مقابل دانشگاه تربيت مدرس - كلينيك باران(عصرها 3تا6) - تلفن ۸۸۳۳۴۹۷۵
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- دسته: خانه
People with major mental disorders such as schizophrenia and bipolar disorder are at increased risk for medical symptoms including overweight, obesity, high cholesterol or triglycerides, diabetes, and the metabolic syndrome, all of which increase risk of cardiovascular disease (heart attack), cerebrovascular disease (or strokes), and other medical difficulties. In a 2013 review article in the journal Bipolar Disorders, researcher Chittaranjan Andrade discussed the use of statins to prevent cardiovascular events in people with major mental disorders.
Statins decrease lipids, and have significant benefits in decreasing cardiac events, but their use is low among psychiatric populations. Psychiatric patients often receive less cardiac care. It may be up to their psychiatrists to push for aggressive prevention of cardiac illnesses.
The most significant side effect of statins is the possibility that they can increase risk of diabetes. In a meta-analysis by Preiss et al., intensive dosing with statins increased the risk of diabetes but also lowered the risk of cardiovascular events. In a year, 1,000 patients would get two extra cases of diabetes but 6.5 fewer cases of cardiovascular events. For patients at high risk for heart attack or stroke, a cardiovascular event is more dangerous than diabetes, so it makes sense to treat these patients with statins. In patients at lower risk, there is some evidence that diabetes risk was a problem mostly in patients with other risk factors for diabetes, including metabolic syndrome, impaired fasting glucose levels, a body mass index of 30 kg/m2 or higher, or glycated haemoglobin A (1c) above 6%.
Most studies of statins are conducted on patients in middle age, but there is a rationale for treating even younger patients with statins. Patients with bipolar disorder develop cardiovascular disease more than a decade earlier than controls. There is some evidence that cholesterol deposits in arteries begin even before age 20, and are cumulative. The risk-benefit ratio for statin use improves with years of use, so starting it earlier may lead to better prevention. Long-term use may reduce the risk of Alzheimer’s disease and Parkinson’s disease and some cancers in addition to reducing heart attacks and strokes.
Despite the risk of diabetes, it is important to consider statin use in psychiatric patients, especially those who receive antipsychotic medications.
ROCKVILLE, Md -- November 25, 2014 -- The US Food and Drug Administration (FDA) is warning that a patient with multiple sclerosis (MS) who was being treated with dimethyl fumarate (Tecfidera) developed progressive multifocal leukoencephalopathy (PML) and later died.
The patient who died was not taking any other drugs that affect the immune system or drugs that are thought to be associated with PML. This is the only confirmed case of this rare and serious brain infection reported in patients taking dimethyl fumarate.
As a result, information describing this case of PML is being added to the drug’s label.
The drug manufacturer, Biogen Idec, notified the FDA when the patient died after developing PML. The patient had taken dimethyl fumarate for more than 4 years. Prior to developing PML, the patient had a very low number of lymphocytes in her blood. It is unknown whether the low lymphocyte count contributed to the development of PML in this patient, or if low lymphocyte counts are a risk factor for PML development in dimethyl fumarate -treated patients.
SOURCE: US Food and Drug Administration