Clozapine Associated Obesity and Diabetes †MyAssignmenthelp.com

Question: Discus about the Clozapine Associated Obesity and Diabetes. Answer: Introduction: The patients who suffer from schizophrenia and take many of the antipsychotic drugs constantly suffer from elevated appetite, which leads them to gain weight consequently and deliberately (Mayfield et al., 2015). The issue addressed in this paper is to measure the outcome of dietary control and exercise program to the patients who is being treated with one particular drug named Clozapine (Zimbron et al., 2016). The idea of the study is definitely novel as the patients who are on the antipsychotic drugs are gaining weight because of their elevated appetite (Hui et al., 2015). Because of their obesity, they are on the high risk of suffering from cardiovascular diseases, diabetes mellitus and hypertension. The outcome of the study would help the physicians to determine whether it is possible to lose weight for a patient with schizophrenia on antipsychotic drug (Rge et al.,2012). The total number of the patients was 53. The dieticians made sure that every female patient is taking 1300 to 1500 calories and every male patient is taking 1600 to 1800 calories per day. The dieticians also maintained the minimum dietary intake of every patient as 1200 and 1500 calories respectively for female and males. The type of food they were eating was fruits, vegetables, sugar free foods and drinks sweetened with artificial sweetener. The whole program for physical activities was for 6 months which was performed thrice a week. The exercise regime for the patients were walking for 1.62 km and climbing 231 stairs (each stair 14 cm) and going down for 330 stairs (each stair 13.5 cm) under 20 minutes of constant supervision. The result of the experiment was positive, as the people in the study group has lost significant amount of weight aster 6 months. The BMI, waist and hip measurement, insulin, triglyceride and IGFBP 3 was also decreased amongst the patients of the study group. IGF1 and IGFBP 3 were increased significantly among these patients. The result also interprets that the drug Clozapine puts the patients under great risk for obesity. To bring the patients in a good health condition, including such programs in the clinics are necessary. Study design: Initially the total numbers of the patients were 53 but three of them have withdrawn from the programs as they were discharged at the second moth of the program. All 53 patients were randomly chosen into two groups, 25 patients (11 male and 14 female) were on the control group and 28 patients were on the study group (11 male and 14 female). All 53 patientsw had a BMI index of 27 and was on the drug Clozapine. The study group went through the diet of taking 1300-1500 calories for female and 1600-1800 calories for males and the exercise program. They lost approximately 600 to 750 calories per week. The scientists measured their metabolic, anthropometric and hormonal parameters after the third and sixth month of the program. At the initial stage the total number of patients were 53 and the scientists put them into two groups, 25 people on the control group and 28 people on the study group. The control group has the mean +_SD age of 39 +_ 6.7 years and the mean age of the study group was 42.2+_ 7.5 years. The experiment was done in the clinical setting. At the second month, three of the patients of the control group left the hospital. All 28 patients of the control group completed the program. The main finding is that the study group has shown significant amount of weight loss after six months. Their waist hip circumference, BMI, diabetes, IGFBP 3 and triglyceride was also reduced. They also showed significant increase of IGF1 and IGFBP 3 molar ratio. The controlled amount of calorie intake and the exercise has also normalized the hormonal change, abnormalities in metabolism and has reduced the side effects of the drugs. The study showed that the drug Clozapine puts the patients with schizophrenia and other neurotic diseases at the risk of being obese and suffering from diabetes and many cardiovascular conditions (Stanley Laugharne, 2012). Those patients who is having Clozapine as the drug of schizophrenia, have to be under regular diet and exercise program to remain healthy (Whitney et al., 2015). To what extent can the observed association between the exposure and outcome be attributed to non-causal explanations? In this article the authors done an intervention in which a registered dietician was appointed for the implementation of the controlled diet. The professional dietician who makes sure that the calorie intake must be maintained at the rate of 1,300 - 1,500 kcal/day for the women and to 1,600 - 1,800 kcal/day for the men. The minimum diet requirements for women were 1,200 kcal per day and for men were 1,500 kcal per day (Manu et al, 2015). They quantified caloric admission and surveyed the sorts of nourishments that the patients ate, including leafy foods (up to 7.5 servings for each day), sugar free forms of sustenances and drinks, and simulated sweeteners. This admission of macronutrients guaranteed that members were consistent with the normal changes of 20%, 25%, and 55% in vitality from protein, fat, and sugar, separately (Godin et al., 2015). In my opinion the outcome states that the 53 obese patients those were treated with clozapine were divide into two groups. 25 people were assigned in the control group and 28 people were assigned to the study group. After I had study this article I found that there were no such differences in between the study group and the control group. At the first stage of the study the fat percentages among the men and the women were similar but at the end of the research the men had significantly less body fat as compared to the women but having more free fat in men. Effect of biases on the presentation of results The current study focussed upon the concept of treatment of patients affected with schizophrenia with clozapine. Reports and evidences have suggested that people with schizophrenia who have undergone treatment with clozapine have deliberately gained weight. In the current study obese people were put under randomised control trails (RCT) were they were put under dietary controls for six month and had undertaken simultaneous physical activities. The goal was to determine the contribution of physical exercises in managing the health condition of a person. In this respect, the patients were divided into a study group of 28 and a control group of 25. The participants of the study group were cut down on the calories intake by 200-300 kcal. Furthermore they were out under strenuous physical exercise such as walking, climbing the stairs and running which helped in burning down their level of fats by 600-700 kcal. Positive results were obtained within the study group compared to the con troll group. Thus, significant results were obtained through Anthropometry and enzyme-linked immune absorbent assay. Thus, over here sufficient reduction in the levels of triglycerides was obtained. Thus, the result was presented in a transparent manner by comparing the data from the two different groups. In my opinion, a number of biases need to be ruled out for the clear presentation of the results. The reduction in weight may also be due the presence of hypothyroidism (Hjorth et al., 2014). In this context, one needs to ensure the exact cause of increase in weight. Sometimes the increase in weight may also be attributed to the presence of a number of other factors such as diabetes and hyperthyroidism (Daumit, 2013). I also think, prior to the formation of the distinct study or control groups detailed health records of the patient groups should also have been taken into consideration. This helps ruling out the possible chances of any errors in the presentation of the results. This investigation exhibits the advantages of a six-month mediation comprising of coordinated dietary control and normal physical action for hefty patients with schizophrenia being treated with clozapine. Our intercession brought about huge reductions in BMI, muscle to fat ratio, and midsection and hip outline. What's more, taking part patients indicated enhanced metabolic profiles of triglyceride, insulin, IGFBP-3 levels, and the IGF-1 to IGFBP-3 molar proportion. Interestingly, the control amass demonstrated no change in anthropometric estimations and no improvement in triglyceride and insulin levels and had a lower molar proportion of IGF-1 to IGFBP-3 (Zimbron et al., 2016). These levels were picked with an end goal to limit any conceivable unfriendly impacts from abstain from food alone, which I saw as mental and passionate flimsiness among the patients who devoured many less calories. The specific physical exercises I find that were chosen were reasonable for fat patients with s chizophrenia on clozapine treatment, since they are mellow and uncomplicated and hold no threat for these patients. Each of the 28 patients in the examination bunch finished the half year eating regimen control mediation and no less than 90% of the physical movement program. The level of consistence and thusly our prosperity rate may have been lower if members had been outpatients as opposed to inpatients. In any case, the high achievement rate made it less demanding to decipher our outcomes toward the finish of the program. Clozapine seems to exhibit extraordinary hazard for weight pick up. Be that as it may, past reports have demonstrated that about half of patients with schizophrenia have comorbid medicinal conditions, and a considerable lot of these sicknesses are misdiagnosed or undiscovered. I suggest that it is urgently imperative to screen the soundness of corpulent patients with schizophrenia who are being treated with clozapine. Since some other metabolic advantages of the eating routine and the activity program were not understood until a half year of intercession, long haul adherence to such a program is essential. I additionally suggest that way of life adjustment (constant dietary control and routine physical movement) be endorsed for these patients with the goal that they can stay away from corpulence related irregularities and appreciate long haul benefits. Thus I can say that there is a direct association between exposure and outcome. The findings of this study is not effective because at the beginning of the study I found that consumption of the clozapine at first reduces the fat but after the long term use of the drug there was seen that the patients were suffering from mood disorder and that will cause a big harm to the schizophrenia patients. External validity and overall quality of the discussion section The research was valid in the sense that a comparative analysis was undertaken for arriving at a possible solution. The participants with long term conditions of schizophrenia and obesity were selected. In this particular aspect, the participants who reportedly showed psychosis owing to presence of other forms of sicknesses such as bipolar disorder or depression were ruled out. The ones who were first generation psychiatric counselling seekers owing to certain forms of trauma or personal life distress were ruled out. In this respect, the researcher also ensured that only supervised users of cloazapine were included for the study design. The discussion had been supported by a number of biochemical assays, which revealed that the patients responded positively for the first six months. However, the patients depicted slight physical weaknesses and mental instabilities in the context of long term dietary restrictions (Andrade et al., 2015). Thus, prolonged dietary restrictions can result in mood disorders in the patients. Hence the paper fails to address these gaps and the possible interventions which could be applied over here. The researchers were limited in their approach over here as they considered only the inpatients for gathering the data. Moreover, the presence of previous or other serious long term sickness was not taken into consideration (Niv et al., 2014). The obesity could also be present within an individual owing to diabetes or other health conditions. However, those records were not taken into consideration. Though the blood tests (ELISA) were performed for the presence of clozapine, I think little eviden ce was gathered which could relate the presence of obesity with clozapine. The participants responded well to the clinical interventions by showing remarkable weight loss at the end of six months. Therefore, the clinical interventions had been successful in evaluation of the required parameters. According to me, one of the loopholes which had been encountered over here is that only inpatients were involved. Therefore, limitation in the size of the population sample could result in the generation of superfluous results. The application of the study design to the population groups can expand the scope of the result. Thus, a large amount of data could be garnered which rules out any possible chances of false or misleading data being generated. References Amiaz, R., Rubinstein, K., Czerniak, E., Karni, Y., Weiser, M. (2016). 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