Antipsychotic-Related Risk for Weight Gain and Metabolic Abnormalities During Development Christoph U. Correll, MD

Size: px
Start display at page:

Download "Antipsychotic-Related Risk for Weight Gain and Metabolic Abnormalities During Development Christoph U. Correll, MD"

Transcription

1 Antipsychotic-Related Risk for Weight Gain and Metabolic Abnormalities During Development Christoph U. Correll, MD Professor of Psychiatry and Molecular Medicine Hofstra North Shore - LIJ School of Medicine Medical Director Recognition and Prevention Program The Zucker Hillside Hospital New York, USA

2 Disclosures: Christoph U. Correll, MD I have an interest in relation with one or more organizations that could be perceived as a possible conflict of interest in the context of this presentation. The relationships are summarized below: Interest Grants Shares Honoraria and Advisory Boards Name of the Organization Bristol-Myers Squibb, Feinstein Institute for Medical Research, Janssen/Johnson & Johnson, National Institute of Mental Health (NIMH), Otsuka, Takeda, Thrasher Foundation None AbbVie, Alkermes, Bristol-Myers Squibb, Eli Lilly, Genentech, Gerson Lehrman Group, IntraCellular Therapies, Janssen/J&J, Lundbeck, MedAvante, Medscape, Otsuka, Pfizer, ProPhase, Reviva, Roche, Sunovion, Supernus, and Takeda.

3 Overview Mental Disorders And Physical Health Mechanisms Antipsychotic Effects Conclusions

4 Mental Disorders and Physical Health

5 2010: Years Lived with Disability MALES FEMALES Vos T et al. Lancet 2012; 380:

6 2010: Disability Adjusted Life Years (DALYs) MALES FEMALES DALYs= Years of Life Lost + Years Lived with Disability Murray C et al. Lancet 2012; 380:

7 Trajectories

8 Early Cardiometabolic Risk Indicator Differentiation In Adults with Psychosis From the General Population Foley D et al. PLoS One Dec 18;8(12):e82606.

9 Hazard Ratios for Risk of DM and CHD By BMI in Adolescence and Adulthood in 37,674 Israeli Men BMI increase: 0.3/year and 15 kg or 4.0 until endpoint Tirosh A. et al. N Engl J Med 2011;364:

10 Antipsychotic Effects

11 Atypical Antipsychotic Use Increasing Dramatically in Youth : Olfson M et al. Arch Gen Psychiatry Jun;63:679-85; Aparasu R & Bhatara V. Curr Med Res Opin Jan;23(1):49-56; Olfson M et al. Arch Gen Psychiatry Dec;69(12): : ~10% of mental health visits involved SGA treatment : 31% of psychiatrists visits involved antipsychotic treatment : DBDs most common diagnoses in child 63% and adolescent (34%) visits

12 2010: Antipsychotic Use in the US by Age and Sex Olfson M et al. JAMA Psychiatry in press.

13 US Trends in Youth s Reporting Severe Mental Health Impairment* and Outpatient Mental Health Service Use Rated by Columbia Impairment Scale (CIS) cut scores; Medical Expenditure Panel Surveys (ages 6-17 years): N=15,307 ( ), N=19,450 ( ), N=18,865 ( ). Olfson M et al. NEJM in press.

14 Main Effect, Mediator and Moderator Model of Antipsychotic Induced Weight Gain Moderators Genetic effects Demographics, setting and illness Drug effects Baseline antipsychotics and co-medications Dose (mg/dl) Changes in neurotransmitters, peptides and hormones regulating appetite and energy homeostasis Baseline diet Baseline BMI Baseline activity Antipsychoticinduced weight change Mediators Dietary changes Activity changes Co-medications Adverse effects Correll CU et al. Trends Mol Med Feb;17(2):97-107

15 12-week Cardiometabolic Effects of SGAs in AP-Naïve Youth Body Weight Fasting Total Cholesterol Fasting Glucose Fasting Triglycerides * Correll CU et al. JAMA 2009;302:

16 Weight Gain > 7% 12-week Weight Gain > 7% (N=541) 100 p=.037 p=.014 p=.015 p< OLZ RIS ZPD QTP APZ AP-Naïve AP-History AP-Switch Correll et al., unpublished data and Correll CU et al. JAMA 2009;302(16):

17 Number needed to harm (NNH) for adverse body composition outcomes Antipsychotic-naïve sample. Total n=272* Outcome variable Aripiprazole (n=41) Olanzapine (n=45) Quetiapine (n=36) Risperidone (n=135) Weight gain >7% 2 (1-3) 1 (1-2) 2 (1-3) 2 (1-3) Weight gain >14% Weight gain >21% 6 (3- ) 2 (1-4) 3 (2-14) 4 (2-31) 20 (6- ) 4 (2-38) 18 (6- ) 15 (5- ) *Includes 15 untreated comparison patients Data are presented as NNT +/- 95% Confidence Interval Calculated from data in Correll CU et al. JAMA 2009;302:

18 No Age Dependent Weight Gain Relative to Baseline Body Weight at 12-weeks with RIS and OLA in Antipsychotic-Naïve Children, Adolescents and Young Adults aged 4-25 years 30 Risperidone: N=167 R 2 =0.011, p= Olanzapine: N=47 R 2 =0.006, p=0.59 WG % change 3 mo WG % change 3 mo Age Age Correll CU et al. Unpublished data.

19 6-Month Categorical Weight and BMI Z Score Changes with RIS, OLA, QUE and in CTRL Youth 6-month weight gain: RIS: 7.1 kg, OLA: 11.5 kg; QUE: 6.3 kg Arango C et al. J Am Acad Child Adolesc Psychiatry. 2014;53(11):

20 6-Month Categorical Cardiometabolic Changes with RIS, OLA, QUE and in CTRL Youth N= 15 N= 279 N= 157 N= 44 N= 47 N= 15 N= 279 N= 157 N= 44 N= 47 N= 15 N= 279 N= 157 N= 44 N= 47 N= 15 N= 279 N= 157 N= 44 N= 47 b 1) 85th BMI %ile + 1 negative weight-related clinical outcome (blood pressure >90 th percentile, total cholesterol 200 mg/dl, LDL-C >130 mg/dl, HDL-C 40 mg/dl, triglycerides 150 mg/dl, or glucose 100 mg/dl) RIS: youth <12 years (N=32) vs 12 yrs (N=125) higher glucose elevation (p<0.0001) Arango C et al. J Am Acad Child Adolesc Psychiatry. 2014;53(11):

21 Percent Percent De Hert M et al., Clin Pract Epidemol Ment Health. 2006;2:14. Metabolic Syndrome Prevalence in Schizophrenia: Effect of Illness (Treatment) Duration (N=415) N=100 First Episode <1.5 yrs N=130 Recent Onset yrs N=106 Subchronic yrs N=79 Chronic >20 yrs N=100 General Population Age 35-<45 Yrs N=100 Schizophrenia Age 35-<45 Yrs N=100 General Population Age Yrs N=100 Schizophrenia Age Yrs

22 ORs for Diabetes Among Antipsychotic Users vs. Non-Users: Greatest Antipsychotic- Related Risk Among Younger Age Groups Hammerman A et al. Ann Pharmacother (9):

23 Time to T2 Diabetes in Youth on Antipsychotics Antipsychotic Users Vs Psychiatric Controls Antipsychotic Users Vs Healthy Controls Galling B et al. in preparation.

24 Dyslipidemia: TG >150 mg/dl, LDL-C or non-hdl-c: >130 mg/dl; HDL-C for males <40 mg/dl, for females <50 mg/dl Correll CU, et al. JAMA Psychiatry Dec 1;71(12): RAISE: Smoking, Lipid Abnormalities, Hypertension Diabetes + Metabolic Syndrome with Related Drug Rx

25 Dyslipidemia: TG >150 mg/dl, LDL-C or non-hdl-c: >130 mg/dl; HDL-C for males <40 mg/dl, for females <50 mg/dl Correll CU, et al. JAMA Psychiatry Dec 1;71(12): RAISE: Smoking, Lipid Abnormalities, Hypertension Diabetes + Metabolic Syndrome with Related Drug Rx

26 Main Cardiometabolic Baseline Results In first-episode schizophrenia patients, despite similar obesity frequency, smoking and metabolic syndrome were more common than in similarly aged general population adults Dyslipidemia, and pre-hypertension were similar only to general population adults aged years older. Total psychiatric illness duration was significantly associated with higher body composition values (BMI, fat mass & percentage, waist circumference). Even brief antipsychotic treatment duration (47.6 days) was associated with higher metabolic values. Very early cardiometabolic effects were greatest for olanzapine (TG, insulin, HOMA), followed by quetiapine (TG/HDL-C ratio). Correll CU et al. JAMA Psychiatry Oct 8. [Epub ahead of print]

27 Prevalence / Lack of Intervention (%) CATIE: Rates of Pharmacological Interventions for Abnormal Blood Pressure, Lipids and Glucose (CATIE = Clinical Antipsychotic Trials of Intervention Effectiveness) n=1488 n=685 n= n=481 n=300 n=75 n=34 n=471 n=421 Hypertension Diabetes Dyslipidaemia Cases Lack of Medical Intervention Nonwhite men treated more for diabetes (p=0.005) and dyslipidaemia (p=0.014) than nonwhite women Nasrallah H, et al. Schizophr Res 2006:86:15 22

28 Lack of Medical Treatment (%) Self-Reported Lack of Medical Treatment in SMI Patients with Directly Assessed Metabolic Syndrome and Self-Reported Hypertension, Hypercholesterolemia and Diabetes / 1359 Metabolic Syndrome 1646/ 3608 Hypertension 2225/ 3732 Elevated Cholesterol 699/ 1754 Diabetes Correll CU et al. Psych Services Sep;61(9):892-8.

29 TERTIARY PREVENTION SECONDARY PRIMARY Medical Risk Management Strategies of Antipsychotic-Treated Patients Treatment Initiation Healthy lifestyle counseling Healthy lifestyle intervention Start with lower-risk antipsychotic If Adverse Effect Is Present Healthy lifestyle counseling/intervention Consider changing to lower-risk antipsychotic Consider weight loss intervention If Adverse Effect Progresses/Serious Healthy lifestyle counseling/intervention Considering changing to lower-risk antipsychotic Add targeted treatment for pathological values Consider referral to specialist Correll CU. CNS Spectr. Vol 12. No 10 (Suppl 17), 2007 :12-20,35.

30 Conclusions Mentally ill individuals are at increased risk for obesity, metabolic abnormalities and related cardiovascular morbidity/mortality. The risk for physical disorders in psychiatric patients is conferred by mental illness, unhealthy lifestyle and psychiatric treatments. Antipsychotic-induced weight gain leads to predictable medical complications. Effects of prior antipsychotic exposure seem to be more relevant than age for weight gain risk. Interactions between mental and medical illness, development of treatments without cardiometabolic risk and prevention require urgent study.

31 To keep the body in good health is a duty... otherwise we shall not be able to keep our mind strong and clear. Buddha

32 Acknowledgements Patients and their families who participated in the SATIETY and RAISE ETP study or who participated in studies that contributed to the development of these studies NIMH for funding SATIETY and RAISE- ETP, NIMH team for supporting RAISE ETP Community clinicians who referred patients or participated in SATIETY and RAISE-ETP

33 Christoph U. Correll, M.D. The Zucker Hillside Hospital Psychiatry Research rd Street Glen Oaks, New York Tel: Fax:

More than We Bargained For: Metabolic Side Effects of Antipsychotic Medications

More than We Bargained For: Metabolic Side Effects of Antipsychotic Medications More than We Bargained For: Metabolic Side Effects of Antipsychotic Medications Michael D. Jibson, MD, PhD Professor of Psychiatry University of Michigan Disclosure In the past 12 months I have received

More information

Diabetes, Diet and SMI: How can we make a difference?

Diabetes, Diet and SMI: How can we make a difference? Diabetes, Diet and SMI: How can we make a difference? Dr. Adrian Heald Consultant in Endocrinology and Diabetes Leighton Hospital, Crewe and Macclesfield Research Fellow, Manchester University Relative

More information

Metabolic Monitoring, Schizophrenia Spectrum Illnesses, & Second Generation Antipsychotics

Metabolic Monitoring, Schizophrenia Spectrum Illnesses, & Second Generation Antipsychotics Metabolic Monitoring, Schizophrenia Spectrum Illnesses, & Second Generation Antipsychotics National Council for Behavioral Health Montefiore Medical Center Northwell Health New York State Office of Mental

More information

Introduction. Objectives. Psychotropic Medications & Cardiometabolic Risk

Introduction. Objectives. Psychotropic Medications & Cardiometabolic Risk Psychotropic Medications & Cardiometabolic Risk Sam Ellis, PharmD, BCPS, CDE Associate Professor University of Colorado School of Pharmacy Introduction Second GenerationAntipsychotics (SGA) first FDA approved

More information

Minimising the Impact of Medication on Physical Health in Schizophrenia

Minimising the Impact of Medication on Physical Health in Schizophrenia Minimising the Impact of Medication on Physical Health in Schizophrenia John Donoghue Liverpool Imagination is more important than knowledge Albert Einstein LIFESTYLE Making choices TREATMENT Worse Psychopathology,

More information

Michael J. Bailey, M.D. OptumHealth Public Sector

Michael J. Bailey, M.D. OptumHealth Public Sector Michael J. Bailey, M.D. OptumHealth Public Sector LIHP Quality Charter To ensure the quality of care delivered to enrollees in San Diego County Assistance Programs, such as County Medical Services (CMS)

More information

Comorbid Conditions and Antipsychotic Use in Patients with Depression

Comorbid Conditions and Antipsychotic Use in Patients with Depression Comorbid Conditions and Antipsychotic Use in Patients with Depression Thomas W. Heinrich, MD Professor of Psychiatry and Family Medicine Director, Division of Consultation-Liaison Psychiatry Medical College

More information

Cardiometabolic Risk in Patients With First-Episode Schizophrenia Spectrum Disorders Baseline Results From the RAISE-ETP Study

Cardiometabolic Risk in Patients With First-Episode Schizophrenia Spectrum Disorders Baseline Results From the RAISE-ETP Study Research Original Investigation Cardiometabolic Risk in Patients With First-Episode Schizophrenia Spectrum Disorders Baseline Results From the RAISE-ETP Study Christoph U. Correll, MD; Delbert G. Robinson,

More information

Epidemiology of Psychosis

Epidemiology of Psychosis Epidemiology of Psychosis Chris Gale Otago Registrar Training Group Feb 2011. Methodologies used. Population surveys. General population. High risk populations. Screener and re-interview. Case records

More information

Hearts and Minds An ECG Update. Tuesday 18 th November The Met Hotel, Leeds

Hearts and Minds An ECG Update. Tuesday 18 th November The Met Hotel, Leeds Hearts and Minds An ECG Update Tuesday 18 th November The Met Hotel, Leeds Ashleigh Bradley Specialist Clinical Pharmacist for Mental Health and Lithium Clinic Airedale NHS Foundation Trust Introduction

More information

THE EVOLUTION OF MAN homo lethargicus gigantico

THE EVOLUTION OF MAN homo lethargicus gigantico THE EVOLUTION OF MAN homo lethargicus gigantico Weight Gain and Metabolic Abnormalities in Patients with Schizophrenia Leslie Citrome, MD, MPH Clinical Professor of Psychiatry and Behavioral Sciences New

More information

Physical Health Management: Why it s important for adolescents and young adults in mental health services

Physical Health Management: Why it s important for adolescents and young adults in mental health services Physical Health Management: Why it s important for adolescents and young adults in mental health services Early Intervention Service Wellington Lauren Heath and Erin Dawson Introduction Second generation

More information

Re: Safety data on Zyprexa (olanzapine) and Symbyax (olanzapine and fluoxetine HCl capsules) Hyperglycemia, Weight Gain, and Hyperlipidemia

Re: Safety data on Zyprexa (olanzapine) and Symbyax (olanzapine and fluoxetine HCl capsules) Hyperglycemia, Weight Gain, and Hyperlipidemia www.lilly.com Eli Lilly and Company Lilly Corporate Center Indianapolis, Indiana 46285 U.S.A. Phone 317 276 2000 October 5, 2007 Re: Safety data on Zyprexa (olanzapine) and Symbyax (olanzapine and fluoxetine

More information

Epidemiology of Psychosis

Epidemiology of Psychosis Epidemiology of Psychosis Chris Gale Otago Registrar Training Group Feb 2011. Methodologies used. Population surveys. General population. High risk populations. Screener and re-interview. Case records

More information

Youth with schizophrenia are at high risk. of diabetes: Opportunities for prevention and early intervention.

Youth with schizophrenia are at high risk. of diabetes: Opportunities for prevention and early intervention. Youth with schizophrenia are at high risk of diabetes: Opportunities for prevention and early intervention. Katherine Samaras Department of Endocrinology, St Vincent s Hospital Diabetes and Obesity Program,

More information

Cardiometabolic Side Effects of Risperidone in Children with Autism

Cardiometabolic Side Effects of Risperidone in Children with Autism Cardiometabolic Side Effects of Risperidone in Children with Autism Susan J. Boorin, MSN, PMHNP-BC PhD Candidate Yale School of Nursing 1 This speaker has no conflicts of interest to disclose. 2 Boorin

More information

Meccanismi fisiopatologici e trattamento dei disturbi metabolici in soggetti affetti da disturbo mentale grave

Meccanismi fisiopatologici e trattamento dei disturbi metabolici in soggetti affetti da disturbo mentale grave Meccanismi fisiopatologici e trattamento dei disturbi metabolici in soggetti affetti da disturbo mentale grave Francesco Bartoli, MD, PhD Università degli Studi di Milano Bicocca Ospedale San Gerardo di

More information

The outlook for schizophrenia is better than we think but is being sabotaged by Assembly-line Psychiatry

The outlook for schizophrenia is better than we think but is being sabotaged by Assembly-line Psychiatry The outlook for schizophrenia is better than we think but is being sabotaged by Assembly-line Psychiatry Robin M Murray Department of Psychosis Studies Institute of Psychiatry King s College London robin.murray@kcl.ac.uk

More information

Pharmacotherapy of psychosis and schizophrenia in youth

Pharmacotherapy of psychosis and schizophrenia in youth Pharmacotherapy of psychosis and schizophrenia in youth Benedetto Vitiello Pavia, 2 December 2017 Disclosure Benedetto Vitiello, M.D. Professor of Child and Adolescent Neuropsychiatry University of Turin,

More information

Overview. Optimizing Treatment in Schizophrenia: An Update. Illness Phases. First Episode

Overview. Optimizing Treatment in Schizophrenia: An Update. Illness Phases. First Episode Overview Optimizing Treatment in : An Update Christoph U. Correll, MD Professor of Psychiatry, Hofstra Northwell School of Medicine Hempstead, New York Medical Director, Recognition and Prevention Program

More information

Supplementary Online Content

Supplementary Online Content Supplementary Online Content Larsen JR, Vedtofte L, Jakobsen MSL, et al. Effect of liraglutide treatment on prediabetes and overweight or obesity in clozapine- or olanzapine-treated patients with schizophrenia

More information

UNDERSTANDING AND MANAGING METABOLIC SYNDROME IN PSYCHIATRY Dr Sanil Rege MBBS, MRCPsych, FRANZCP Consultation-Liaison Psychiatry PaRK MHS, Western

UNDERSTANDING AND MANAGING METABOLIC SYNDROME IN PSYCHIATRY Dr Sanil Rege MBBS, MRCPsych, FRANZCP Consultation-Liaison Psychiatry PaRK MHS, Western UNDERSTANDING AND MANAGING METABOLIC SYNDROME IN PSYCHIATRY Dr Sanil Rege MBBS, MRCPsych, FRANZCP Consultation-Liaison Psychiatry PaRK MHS, Western Australia Talks Facilitator of the CTF Exam Prep Course

More information

APNA 27th Annual Conference Session 2036: October 10, 2013

APNA 27th Annual Conference Session 2036: October 10, 2013 Leigh Powers DNP, MSN, MS, BS, APRN, PMHNP BC APNA Annual Conference October 10, 2013 *The speaker has no conflicts of interest to disclose Compare quality of care through measurement of adherence to a

More information

Sugar-Loaded Beverages and the Impact on Cardiovascular Health. Christina M. Shay, PhD, MA

Sugar-Loaded Beverages and the Impact on Cardiovascular Health. Christina M. Shay, PhD, MA Sugar-Loaded Beverages and the Impact on Cardiovascular Health Christina M. Shay, PhD, MA 1 Presenter Disclosure Information Christina M. Shay, PhD, MA Sugar-Loaded Beverages and the Impact on Cardiovascular

More information

Cardiometabolic Risk Factors and Antipsychotic Medications Changing Prescribing Practices Promoting Wellness

Cardiometabolic Risk Factors and Antipsychotic Medications Changing Prescribing Practices Promoting Wellness Cardiometabolic Risk Factors and Antipsychotic Medications Changing Prescribing Practices Promoting Wellness Sally Ricketts, M.D. New York State Office of Mental Health Bureau of Evidence-Based Services

More information

UC San Francisco UC San Francisco Previously Published Works

UC San Francisco UC San Francisco Previously Published Works UC San Francisco UC San Francisco Previously Published Works Title Roles in and barriers to metabolic screening for people taking antipsychotic medications: A survey of psychiatrists Permalink https://escholarship.org/uc/item/6xh6w409

More information

Hypertension in 2015: SPRINT-ing ahead of JNC-8. MAJ Charles Magee, MD MPH FACP Director, WRNMMC Hypertension Clinic

Hypertension in 2015: SPRINT-ing ahead of JNC-8. MAJ Charles Magee, MD MPH FACP Director, WRNMMC Hypertension Clinic Hypertension in 2015: SPRINT-ing ahead of JNC-8 MAJ Charles Magee, MD MPH FACP Director, WRNMMC Hypertension Clinic Conflits of interest? None Disclaimer The opinions contained herein are not to be considered

More information

Clinical Update on the Management of Schizophrenia

Clinical Update on the Management of Schizophrenia Clinical Update on the Management of Schizophrenia L. Fredrik Jarskog, M.D. Professor of Psychiatry Research Director, North Carolina Psychiatric Research Center UNC-Chapel Hill Disclosures Past 3 years:

More information

The Contribution of Abdominal Obesity and Dyslipidemia to Metabolic Syndrome in Psychiatric Patients

The Contribution of Abdominal Obesity and Dyslipidemia to Metabolic Syndrome in Psychiatric Patients ORIGINAL ARTICLE DOI: 10.3904/kjim.2010.25.2.168 The Contribution of Abdominal Obesity and Dyslipidemia to Metabolic Syndrome in Psychiatric Patients Sung-Hwan Kim 1, Kiwon Kim 2, Mi Hyang Kwak 2, Hak

More information

Metabolic Syndrome Update The Metabolic Syndrome: Overview. Global Cardiometabolic Risk

Metabolic Syndrome Update The Metabolic Syndrome: Overview. Global Cardiometabolic Risk Metabolic Syndrome Update 21 Marc Cornier, M.D. Associate Professor of Medicine Division of Endocrinology, Metabolism & Diabetes University of Colorado Denver Denver Health Medical Center The Metabolic

More information

Number needed to treat (NNT) is a measure of

Number needed to treat (NNT) is a measure of For mass reproduction, content licensing and permissions contact Dowden Health Media. p sychiatry Can you interpret confidence intervals? It s not that difficult NNT medicine s secret stat offers infinite

More information

Early Intervention in Psychosis... Dec 7 th Wakefield

Early Intervention in Psychosis... Dec 7 th Wakefield Early Intervention in Psychosis... Dec 7 th Wakefield David.Shiers@doctors.org.uk Declaration of Interest: 1. Member of two Guideline Development Groups (GDG) for NICE: a) NICE guidance for children and

More information

Is Universal Pediatric Lipid Screening Justified? YES. Damon Dixon, MD, FAAP Preventative Cardiology March 7 th, 2016

Is Universal Pediatric Lipid Screening Justified? YES. Damon Dixon, MD, FAAP Preventative Cardiology March 7 th, 2016 Is Universal Pediatric Lipid Screening Justified? YES Damon Dixon, MD, FAAP Preventative Cardiology March 7 th, 2016 None Disclosures What is a Pediatrician? Pediatrics is the specialty of medical science

More information

Total risk management of Cardiovascular diseases Nobuhiro Yamada

Total risk management of Cardiovascular diseases Nobuhiro Yamada Nobuhiro Yamada The worldwide burden of cardiovascular diseases (WHO) To prevent cardiovascular diseases Beyond LDL Multiple risk factors With common molecular basis The Current Burden of CVD CVD is responsible

More information

In recent years, reports of diabetes, diabetic

In recent years, reports of diabetes, diabetic A REVIEW OF METABOLIC ISSUES IN ATYPICAL ANTIPSYCHOTIC TREATMENT John W. Newcomer, MD, * and Henry A. Nasrallah, MD ABSTRACT Reports of diabetes, diabetic ketoacidosis, hyperglycemia, and dyslipidemias

More information

Managing metabolic syndrome in a partial hospitalization program: a feasibility study. Life Enhancement program. The Queen s Medical Center

Managing metabolic syndrome in a partial hospitalization program: a feasibility study. Life Enhancement program. The Queen s Medical Center Day Treatment Services Managing metabolic syndrome in a partial hospitalization program: a feasibility study Renee Latimer, APRN-BC, MS, MPH Rose Clute, APRN-BC, Rx, MS Life Enhancement Program Honolulu,

More information

Should Psychiatrists be diagnosing (and treating) metabolic syndrome

Should Psychiatrists be diagnosing (and treating) metabolic syndrome Should Psychiatrists be diagnosing (and treating) metabolic syndrome David Hopkins Clinical Director, Diabetes King s College Hospital, London Diabetes prevalence (thousands) Diabetes in the UK: 1995-2010

More information

Hypertension with Comorbidities Treatment of Metabolic Risk Factors in Children and Adolescents

Hypertension with Comorbidities Treatment of Metabolic Risk Factors in Children and Adolescents Hypertension with Comorbidities Treatment of Metabolic Risk Factors in Children and Adolescents Stella Stabouli Ass. Professor Pediatrics 1 st Department of Pediatrics Hippocratio Hospital Evaluation of

More information

PRIMARY CARE MANAGEMENT OF OBESITY

PRIMARY CARE MANAGEMENT OF OBESITY Psychiatry and Addictions Case Conference UW Medicine Psychiatry and Behavioral Sciences PRIMARY CARE MANAGEMENT OF OBESITY LYDIA CHWASTIAK MD, MPH ASSOCIATE PROFESSOR UNIVERSITY OF WASHINGTON DEPARTMENT

More information

University of Groningen

University of Groningen University of Groningen A 12-month follow-up study of treating overweight schizophrenic patients with aripiprazole Schorr, S. G.; Slooff, C. J.; Postema, R.; Van Oven, W.; Schilthuis, M.; Bruggeman, Richard;

More information

Aussagekraft von Metaanalysen. Prof. Stefan Leucht Klinik für Psychiatrie und Psychotherapie der TU-München

Aussagekraft von Metaanalysen. Prof. Stefan Leucht Klinik für Psychiatrie und Psychotherapie der TU-München Aussagekraft von Metaanalysen Prof. Stefan Leucht Klinik für Psychiatrie und Psychotherapie der TU-München Disclosures In the past 3 years: Consulting/advisory board honoraria from Alkermes, Bristol- Myers

More information

Schizophrenia: Treating The Whole Person

Schizophrenia: Treating The Whole Person Schizophrenia: Treating The Whole Person Jacob S. Ballon, M.D., M.P.H & Douglas L. Noordsy, M.D. INSPIRE Clinic PEPPNET Prodrome and Early Psychosis Program NETwork Stanford University Department of Psychiatry

More information

Effective Interventions in the Clinical Setting: Engaging and Empowering Patients. Michael J. Bloch, M.D. Doina Kulick, M.D.

Effective Interventions in the Clinical Setting: Engaging and Empowering Patients. Michael J. Bloch, M.D. Doina Kulick, M.D. Effective Interventions in the Clinical Setting: Engaging and Empowering Patients Michael J. Bloch, M.D. Doina Kulick, M.D. UNIVERSITY OF NEVADA SCHOOL of MEDICINE Sept. 8, 2011 Reality check: What could

More information

Curr Opin Psychiatry 21: ß 2008 Wolters Kluwer Health Lippincott Williams & Wilkins

Curr Opin Psychiatry 21: ß 2008 Wolters Kluwer Health Lippincott Williams & Wilkins Addressing cardiometabolic risk during treatment with antipsychotic medications Jonathan M. Amiel a,b, Christina V. Mangurian a,b, Rohan Ganguli c,d and John W. Newcomer e a Columbia University College

More information

Objectives. Pre Discussion Question #2. Disparity in Care Demographics

Objectives. Pre Discussion Question #2. Disparity in Care Demographics Objectives Implementation of a pharmacist driven metabolic monitoring protocol for second generation antipsychotics (SGAs) Jonathan Willett, PharmD PGY 1 Pharmacy Practice Resident Chickasaw Nation March

More information

University of Groningen. Metabolic risk in people with psychotic disorders Bruins, Jojanneke

University of Groningen. Metabolic risk in people with psychotic disorders Bruins, Jojanneke University of Groningen Metabolic risk in people with psychotic disorders Bruins, Jojanneke IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from

More information

Preventing Disability: Examining Outcomes for New Youth Psychosis Treatments

Preventing Disability: Examining Outcomes for New Youth Psychosis Treatments Preventing Disability: Examining Outcomes for New Youth Psychosis Treatments John M. Kane, M.D. Professor and Chairman The Zucker Hillside Hospital and Hofstra North Shore-LIJ School of Medicine Senior

More information

People with Serious Mental. Morbidity and Mortality in. Morbidity and Mortality in. Illness National Association of State Mental Health Program

People with Serious Mental. Morbidity and Mortality in. Morbidity and Mortality in. Illness National Association of State Mental Health Program Morbidity and Mortality in Morbidity and Mortality in People with Serious Mental Illness National Association of State Mental Health Program Directors Medical Directors Council July 2006 Overview- THE

More information

November 2014 MRC2.CORP.X.00004

November 2014 MRC2.CORP.X.00004 This program is paid for by Otsuka America Pharmaceutical, Inc. and Lundbeck, LLC. The speaker is a paid consultant of Otsuka America Pharmaceutical, Inc. advice or professional diagnosis. Users seeking

More information

Metabolic Syndrome. Shon Meek MD, PhD Mayo Clinic Florida Endocrinology

Metabolic Syndrome. Shon Meek MD, PhD Mayo Clinic Florida Endocrinology Metabolic Syndrome Shon Meek MD, PhD Mayo Clinic Florida Endocrinology Disclosure No conflict of interest No financial disclosure Does This Patient Have Metabolic Syndrome? 1. Yes 2. No Does This Patient

More information

Objectives. Disclosure of Commercial Support. Psychopharmacology and Pediatric Obesity

Objectives. Disclosure of Commercial Support. Psychopharmacology and Pediatric Obesity Psychopharmacology and Pediatric Obesity Raise awareness of the complex interplay between mental illness and obesity/metabolic disturbances in children Dina Panagiotopoulos, MD, FRCPC Clinical Professor

More information

Collaborating, Co-managing and Facilitating Metabolic Improvement in Patients with Severe Mental Illness (SMI)

Collaborating, Co-managing and Facilitating Metabolic Improvement in Patients with Severe Mental Illness (SMI) Collaborating, Co-managing and Facilitating Metabolic Improvement in Patients with Severe Mental Illness (SMI) 14 th Canadian Collaborative Mental Health Care Conference Montréal, Québec June 28, 2013

More information

Overweight and Obesity in Older Persons: Impact Upon Health and Mortality Outcomes

Overweight and Obesity in Older Persons: Impact Upon Health and Mortality Outcomes Overweight and Obesity in Older Persons: Impact Upon Health and Mortality Outcomes Gordon L Jensen, MD, PhD Senior Associate Dean for Research Professor of Medicine and Nutrition Objectives Health outcomes

More information

OBESITY IN PRIMARY CARE

OBESITY IN PRIMARY CARE OBESITY IN PRIMARY CARE Obesity- definition Is a chronic disease In ICD 10 E66 Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health. Obesity is a leading

More information

The prevalence of many physical illnesses is increased

The prevalence of many physical illnesses is increased Cardiovascular disease and diabetes in people with severe mental illness: causes, consequences and pragmatic management RICHARD IG HOLT The prevalence of many physical illnesses is increased in people

More information

Aggressive Lipid Management for Diabetes

Aggressive Lipid Management for Diabetes Aggressive Lipid Management for Diabetes Practical Ways to Achieve Targets in Diabetes Care Keystone, CO July 16, 2011 Robert H. Eckel, M.D. Professor of Medicine Professor of Physiology and Biophysics

More information

Antipsychotic Medications

Antipsychotic Medications TRAIL: Team Review of EVIDENCE REVIEW & RECOMMENDATIONS FOR LTC Behavioural and psychological symptoms of dementia (BPSD) refer to the non-cognitive symptoms of disturbed perception, thought content, mood

More information

Know Your Number Aggregate Report Single Analysis Compared to National Averages

Know Your Number Aggregate Report Single Analysis Compared to National Averages Know Your Number Aggregate Report Single Analysis Compared to National s Client: Study Population: 2242 Population: 3,000 Date Range: 04/20/07-08/08/07 Version of Report: V6.2 Page 2 Study Population Demographics

More information

Recent Advances in the Antipsychotic Treatment of People with schizophrenia. Robert W. Buchanan, M.D.

Recent Advances in the Antipsychotic Treatment of People with schizophrenia. Robert W. Buchanan, M.D. Recent Advances in the Antipsychotic Treatment of People with schizophrenia Robert W. Buchanan, M.D. Antipsychotic medications are the primary class of drugs used in the pharmacological treatment of schizophrenia.

More information

Client Report Screening Program Results For: Missouri Western State University October 28, 2013

Client Report Screening Program Results For: Missouri Western State University October 28, 2013 Client Report For: Missouri Western State University October 28, 2013 Executive Summary PROGRAM OVERVIEW From 1/1/2013-9/30/2013, Missouri Western State University participants participated in a screening

More information

Severe Mental Illness and Diabetes. Charlie Place

Severe Mental Illness and Diabetes. Charlie Place Severe Mental Illness and Diabetes Charlie Place Intro Me Community Mental Health Nurse Case manager for Assertive Outreach Team in Leeds Severe Mental Illness (SMI) usually diagnosis of schizophrenia

More information

Table of Contents. 1.0 Policy Statement...1

Table of Contents. 1.0 Policy Statement...1 Division of Medical Assistance General Clinical Policy No. A-6 Table of Contents 1.0 Policy Statement...1 2.0 Policy Guidelines...1 2.1 Eligible Recipients...1 2.1.1 General Provisions...1 2.1.2 EPSDT

More information

PREVALENCE OF METABOLİC SYNDROME İN CHİLDREN AND ADOLESCENTS

PREVALENCE OF METABOLİC SYNDROME İN CHİLDREN AND ADOLESCENTS PREVALENCE OF METABOLİC SYNDROME İN CHİLDREN AND ADOLESCENTS Mehmet Emre Atabek,MD,PhD Necmettin Erbakan University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology and

More information

4/29/2016. Psychosis A final common pathway. Early Intervention in Psychotic Disorders: Necessary, Effective, and Overdue

4/29/2016. Psychosis A final common pathway. Early Intervention in Psychotic Disorders: Necessary, Effective, and Overdue Early Intervention in Psychotic Disorders: Necessary, Effective, and Overdue Disclosures Financial relationships with commercial interests Douglas R. Robbins, M.D. Maine Medical Center Tufts University

More information

INSIGHTS INTO ADDRESSING EARLY SCHIZOPHRENIA: PRODROME AND FIRST EPISODE

INSIGHTS INTO ADDRESSING EARLY SCHIZOPHRENIA: PRODROME AND FIRST EPISODE INSIGHTS INTO ADDRESSING EARLY SCHIZOPHRENIA: PRODROME AND FIRST EPISODE S. Charles Schulz, MD Professor & Head Donald W. Hastings Endowed Chair Department of Psychiatry University of Minnesota Medical

More information

Weight Gain and Severe Mental Illness: a Double Blow.

Weight Gain and Severe Mental Illness: a Double Blow. Weight Gain and Severe Mental Illness: a Double Blow. Dr David Shiers GP Advisor National Audit of Schizophrenia Dec 13 th Public Mental Health Seminar Declaration of Interest: Member of two Guideline

More information

Is Depression management getting you down? G. Michael Allan Director Programs and Practice Support, CFPC Professor, Family Med, U of A

Is Depression management getting you down? G. Michael Allan Director Programs and Practice Support, CFPC Professor, Family Med, U of A Is Depression management getting you down? G. Michael Allan Director Programs and Practice Support, CFPC Professor, Family Med, U of A Faculty/Presenter Disclosures Faculty: Mike Allan Salary: College

More information

Know Your Number Aggregate Report Comparison Analysis Between Baseline & Follow-up

Know Your Number Aggregate Report Comparison Analysis Between Baseline & Follow-up Know Your Number Aggregate Report Comparison Analysis Between Baseline & Follow-up... Study Population: 340... Total Population: 500... Time Window of Baseline: 09/01/13 to 12/20/13... Time Window of Follow-up:

More information

Case Presentation. Rafael Bitzur The Bert W Strassburger Lipid Center Sheba Medical Center Tel Hashomer

Case Presentation. Rafael Bitzur The Bert W Strassburger Lipid Center Sheba Medical Center Tel Hashomer Case Presentation Rafael Bitzur The Bert W Strassburger Lipid Center Sheba Medical Center Tel Hashomer Case Presentation 50 YO man NSTEMI treated with PCI 1 month ago Medical History: Obesity: BMI 32,

More information

Handout for the Neuroscience Education Institute (NEI) online activity: First-Episode Schizophrenia: Setting the Stage for Successful Outcomes

Handout for the Neuroscience Education Institute (NEI) online activity: First-Episode Schizophrenia: Setting the Stage for Successful Outcomes Handout for the Neuroscience Education Institute (NEI) online activity: First-Episode Schizophrenia: Setting the Stage for Successful Outcomes Learning Objectives Initiate low-dose antipsychotic medication

More information

Dyslipidemia in women: Who should be treated and how?

Dyslipidemia in women: Who should be treated and how? Dyslipidemia in women: Who should be treated and how? Lale Tokgozoglu, MD, FACC, FESC Professor of Cardiology Hacettepe University Faculty of Medicine Ankara, Turkey. Cause of Death in Women: European

More information

Elevated Serum Levels of Adropin in Patients with Type 2 Diabetes Mellitus and its Association with

Elevated Serum Levels of Adropin in Patients with Type 2 Diabetes Mellitus and its Association with Elevated Serum Levels of Adropin in Patients with Type 2 Diabetes Mellitus and its Association with Insulin Resistance Mehrnoosh Shanaki, Ph.D. Assistant Professor of Clinical Biochemistry Shahid Beheshti

More information

Screening for the metabolic syndrome in patients receiving antipsychotic treatment: a proposed algorithm

Screening for the metabolic syndrome in patients receiving antipsychotic treatment: a proposed algorithm Screening for the metabolic syndrome in patients receiving antipsychotic treatment: a proposed algorithm Anna J Waterreus and Jonathan D E Laugharne In 2001, the University of Western Australia s Centre

More information

Is Depression management getting you down? G. Michael Allan Director Programs and Practice Support, CFPC Professor, Family Med, U of A

Is Depression management getting you down? G. Michael Allan Director Programs and Practice Support, CFPC Professor, Family Med, U of A Is Depression management getting you down? G. Michael Allan Director Programs and Practice Support, CFPC Professor, Family Med, U of A Faculty/Presenter Disclosures Faculty: Mike Allan Salary: College

More information

Why are NICE guidelines and standards important and relevant to us?

Why are NICE guidelines and standards important and relevant to us? Why are NICE guidelines and standards important and relevant to us? Dr Liz England GP, Laurie Pike health centre RCGP Mental Health Clinical and Commissioning Lead SWB CCG Mental Health Lead NIHR Clinical

More information

Antidepressant Therapy 2016

Antidepressant Therapy 2016 Antidepressant Therapy 2016 Michael E. Thase, MD University of Pennsylvania School of Medicine Philadelphia Veterans Affairs Medical Center University of Pittsburgh Medical Center thase@mail.med.upenn.edu

More information

February 7-9, 2019 The Westin Fort Lauderdale Florida. Provided by

February 7-9, 2019 The Westin Fort Lauderdale Florida. Provided by February 7-9, 2019 The Westin Fort Lauderdale Florida Provided by Addressing Your Greatest Concerns in Schizophrenia Management: From Suicide to Relapse Prevention and the Role of LAIs John Lauriello,

More information

Metabolism, Atherogenic Properties and Agents to reduce Triglyceride-Rich Lipoproteins Manfredi Rizzo, MD, PhD

Metabolism, Atherogenic Properties and Agents to reduce Triglyceride-Rich Lipoproteins Manfredi Rizzo, MD, PhD Metabolism, Atherogenic Properties and Agents to reduce Triglyceride-Rich Lipoproteins Manfredi Rizzo, MD, PhD Associate Professor of Internal Medicine Faculty of Medicine, University of Palermo, Italy

More information

EARLY ONSET SCHIZOPHRENIA

EARLY ONSET SCHIZOPHRENIA Psychiatry and Addictions Case Conference UW Medicine Psychiatry and Behavioral Sciences EARLY ONSET SCHIZOPHRENIA JON MCCLELLAN CHILD STUDY AND TREATMENT CENTER GENERAL DISCLOSURES The University of Washington

More information

Figure S1. Comparison of fasting plasma lipoprotein levels between males (n=108) and females (n=130). Box plots represent the quartiles distribution

Figure S1. Comparison of fasting plasma lipoprotein levels between males (n=108) and females (n=130). Box plots represent the quartiles distribution Figure S1. Comparison of fasting plasma lipoprotein levels between males (n=108) and females (n=130). Box plots represent the quartiles distribution of A: total cholesterol (TC); B: low-density lipoprotein

More information

Metabolic Syndrome Across the Life Cycle - Adolescent. Joy Friedman MD

Metabolic Syndrome Across the Life Cycle - Adolescent. Joy Friedman MD Metabolic Syndrome Across the Life Cycle - Adolescent Joy Friedman MD Disclosures I have no actual or potential conflict of interest in relation to this program or presentation. I will mention off-label

More information

Management of Obesity. Objectives. Background Impact and scope of Obesity. Control of Energy Homeostasis Methods of treatment Medications.

Management of Obesity. Objectives. Background Impact and scope of Obesity. Control of Energy Homeostasis Methods of treatment Medications. Medical Management of Obesity Ben O Donnell, MD 1 Objectives Background Impact and scope of Obesity Control of Energy Homeostasis Methods of treatment Medications 2 O'Donnell 1 Impact of Obesity According

More information

D I A G N O S I S ADD/ADHD. Conduct Disorder. Oppositional. Oppositional Defiant Disorder. Defiant. Anxiety Disorder. Adjustment.

D I A G N O S I S ADD/ADHD. Conduct Disorder. Oppositional. Oppositional Defiant Disorder. Defiant. Anxiety Disorder. Adjustment. Dr. Crismon has no potential conflicts of interest to disclose with regard to this presentation. M. Lynn Crismon, Pharm.D., FCCP, BCPP Dean James T. Doluisio Regents Chair & Behrens Centennial Professor

More information

ESSENTIAL SHARED CARE AGREEMENT FOR Risperidone, Olanzapine, Quetiapine, Aripiprazole, Amisulpride (South Staffordshire Only)

ESSENTIAL SHARED CARE AGREEMENT FOR Risperidone, Olanzapine, Quetiapine, Aripiprazole, Amisulpride (South Staffordshire Only) E099 ESSENTIAL SHARED CARE AGREEMENT FOR Risperidone, Olanzapine, Quetiapine, Aripiprazole, Amisulpride (South Staffordshire Only) NOTE: Please complete details on P1 &3 Send one copy to GP, Patient and

More information

Why is Earlier and More Aggressive Treatment of T2 Diabetes Better?

Why is Earlier and More Aggressive Treatment of T2 Diabetes Better? Blood glucose (mmol/l) Why is Earlier and More Aggressive Treatment of T2 Diabetes Better? Disclosures Dr Kennedy has provided CME, been on advisory boards or received travel or conference support from:

More information

The Brain and the Body: Medical Comorbidities in Psychiatric Illness. Kate Miley, CNP Psychiatric Nurse Practitioner, HCMC Adult Psychiatry Clinic

The Brain and the Body: Medical Comorbidities in Psychiatric Illness. Kate Miley, CNP Psychiatric Nurse Practitioner, HCMC Adult Psychiatry Clinic The Brain and the Body: Medical Comorbidities in Psychiatric Illness Kate Miley, CNP Psychiatric Nurse Practitioner, HCMC Adult Psychiatry Clinic The Problem: Health Disparities in SMI Life expectancy

More information

Case Studies The Role of Non-Statin Therapies for LDL-C Lowering in the Management of ASCVD Risk

Case Studies The Role of Non-Statin Therapies for LDL-C Lowering in the Management of ASCVD Risk Case Studies The Role of Non-Statin Therapies for LDL-C Lowering in the Management of ASCVD Risk Kim K. Birtcher, PharmD, MS, AACC Clinical Professor University of Houston College of Pharmacy Houston,

More information

What Have We Learned from Meta-analyses of Clinical Trials

What Have We Learned from Meta-analyses of Clinical Trials Prevention in Schizophrenia: The Earlier Use of Long Acting Injectable Medications What Have We Learned from Meta-analyses of Clinical Trials 2016 IPS: The Mental Health Services Conference in Washington

More information

Cardiovascular Risk Assessment and Management Making a Difference

Cardiovascular Risk Assessment and Management Making a Difference Cardiovascular Risk Assessment and Management Making a Difference Norman Sharpe March 2014 Numbers and age-standardised mortality rates from all causes, by sex, 1950 2010 Death rates halved Life expectancy

More information

Mental Health Clinical Pathways Group. The Case for Change

Mental Health Clinical Pathways Group. The Case for Change Mental Health Clinical Pathways Group The Case for Change Contents 1. Executive summary 2. Introduction 2.1. What is severe mental illness? 2.2. Findings of the Disability Rights Commission 3. Physical

More information

INTERNATIONAL LIPOPROTEIN STANDARDIZATION FORUM Fasting Time and Lipid Levels in a Community-Based Population: A Crosssectional

INTERNATIONAL LIPOPROTEIN STANDARDIZATION FORUM Fasting Time and Lipid Levels in a Community-Based Population: A Crosssectional INTERNATIONAL LIPOPROTEIN STANDARDIZATION FORUM Fasting Time and Lipid Levels in a Community-Based Population: A Crosssectional Study. Christopher Naugler MD Associate Professor, University of Calgary

More information

Diabetes Day for Primary Care Clinicians Advances in Diabetes Care

Diabetes Day for Primary Care Clinicians Advances in Diabetes Care Diabetes Day for Primary Care Clinicians Advances in Diabetes Care Elliot Sternthal, MD, FACP, FACE Chair New England AACE Diabetes Day Planning Committee Welcome and Introduction This presentation will:

More information

Fructose in diabetes: Friend or Foe. Kim Chong Hwa MD,PhD Sejong general hospital, Division of Endocrinology & Metabolism

Fructose in diabetes: Friend or Foe. Kim Chong Hwa MD,PhD Sejong general hospital, Division of Endocrinology & Metabolism Fructose in diabetes: Friend or Foe Kim Chong Hwa MD,PhD Sejong general hospital, Division of Endocrinology & Metabolism Contents What is Fructose? Why is Fructose of Concern? Effects of Fructose on glycemic

More information

The Metabolic Syndrome: Is It A Valid Concept? YES

The Metabolic Syndrome: Is It A Valid Concept? YES The Metabolic Syndrome: Is It A Valid Concept? YES Congress on Diabetes and Cardiometabolic Health Boston, MA April 23, 2013 Edward S Horton, MD Joslin Diabetes Center Harvard Medical School Boston, MA

More information

Key Nutritional Considerations & Lab Markers as Adjuncts in Effective Lipid Management. Carmen Ritz, MS Clinical Physiologist

Key Nutritional Considerations & Lab Markers as Adjuncts in Effective Lipid Management. Carmen Ritz, MS Clinical Physiologist Key Nutritional Considerations & Lab Markers as Adjuncts in Effective Lipid Management Carmen Ritz, MS Clinical Physiologist The Ideal Biomarker to identify risk for CVD Specific accurately identifies

More information

Prevalence of Metabolic Syndrome in Psychiatric Outpatients in a Tertiary Care Hospital, Kerala.

Prevalence of Metabolic Syndrome in Psychiatric Outpatients in a Tertiary Care Hospital, Kerala. Indian Journal of Pharmacy Practice Association of Pharmaceutical Teachers of India Prevalence of Metabolic Syndrome in Psychiatric Outpatients in a Tertiary Care Hospital, Kerala. 1 3 Linu Mohan P*, Jishnu

More information

Physical health assessment and monitoring in long-term mental health care

Physical health assessment and monitoring in long-term mental health care Physical health assessment and monitoring in long-term mental health care Dr Alan Farmer Consultant Psychiatrist Worcestershire Mental Health Partnership NHS Trust A brief questionnaire Current thoughts,

More information

Exercise Studies Where Walking is Better than Running: Does Intensity Matter?

Exercise Studies Where Walking is Better than Running: Does Intensity Matter? Exercise Studies Where Walking is Better than Running: Does Intensity Matter? Frontiers in Medicine The Forest 24 September 2018 William E. Kraus, M.D. Exercise Intensity and Volume Effects: Confounded?

More information

PIEDMONT ACCESS TO HEALTH SERVICES, INC. Guidelines for Screening and Management of Dyslipidemia

PIEDMONT ACCESS TO HEALTH SERVICES, INC. Guidelines for Screening and Management of Dyslipidemia PIEDMONT ACCESS TO HEALTH SERVICES, INC. Policy Number: 01-09-021 SUBJECT: Guidelines for Screening and Management of Dyslipidemia EFFECTIVE DATE: 04/2008 REVIEWED/REVISED: 04/12/10, 03/17/2011, 4/10/2012,

More information

The Pharmacological Management of Bipolar Disorder: An Update

The Pharmacological Management of Bipolar Disorder: An Update Psychobiology Research Group The Pharmacological Management of Bipolar Disorder: An Update R. Hamish McAllister-Williams, MD, PhD, FRCPsych Reader in Clinical Psychopharmacology Newcastle University Hon.

More information