Oral Glucose Tolerance Test (OGTT) for Schizophrenia

Findings from a recent study indicates that around 12% of Americans were diagnosed with a psychotic disorder in a year. It is predicted that this will increase by 50% in the next decade. These figures imply that the prevalence of schizophrenia and other psychosis will be substantial over the coming years. The authors conclude that these findings highlight the need for early identification and treatment of psychosis.

Schizophrenia is a serious condition of unknown cause and is characterized by hallucinations, disorganized speech, disorganized or catatonic behavior, anhedonia, loss of motivation, and reduced emotional expressions. Schizophrenic patients display deficits in memory, psychomotor speed and working memory. About 90% of untreated schizophrenia cases develop from depression, and 50% of depressed patients develop schizophrenia. There appears to be a genetic component in schizophrenia; however, how this applies to depression remains speculative.

In a randomized clinical trial evaluating the efficacy of treatment duration and medication (citing as examples aripiprazole, risperidone, perphenazine, haloperidol, and sulpiride), there were significant benefits for both. Also, in a long-term randomized controlled trial evaluating the efficacy of a multimodal treatment regimen that included typical and atypical antipsychotics, at least 2 common treatments were no better than placebo in alleviating symptoms. On the other hand, a meta-analysis by the Cochrane Collaboration published in 2010 of ten trials involving antipsychotic drugs showed that antipsychotic drugs were not statistically significantly more effective than placebo in alleviating core symptoms in schizophrenia and improving overall functioning.

The major features of schizophrenia include disorganized speech, disorganized thoughts, hallucinations, and deficits in judgment that lead to a lack of insight. Other symptoms of schizophrenia include a positive psychotic disorder that results in delusions or hallucinations and disordered thinking due to mood impairment.\n

The exact cause of schizophrenia is unknown, since many theories exist. The most accepted theory is neurodegeneration. However, it is not enough because no cure exists in the entire world. In many regions around the globe, schizophrenia is treated with psychiatric drugs in order to reduce the negative effects of the disease. More studies have to be done to verify whether the most effective drugs are safe and effective.

There is some hope for the future treatment of schizophrenia: with current treatment options, up to 75% of patients can be expected to respond to current therapies over time: by the age of 50, most will be free of symptoms for their lifetimes. However, while the underlying causation of schizophrenia is uncertain, a cure would be far from being feasible – with current treatments, the disease is probably incurable. There may be a case, however, for using drugs therapeutically to reduce psychotic symptoms; however, this would not be a cure. A cure for schizophrenia would take time: over 20 years before an entirely efficacious treatment for the disease could be produced, if ever possible.

Side effects of intravenous ogtt are also common. These include feeling tired after the test, nausea, vomiting, a fast heart rate, dry hair, itchiness, muscle contractions (twitching), high blood pressure, dizziness, sweating, trouble sleeping, and anxiety. There were not statistically significant differences in side effects between group A and group B at post-test 1.

The findings, obtained from our study, seem to emphasize the importance of blood glucose level as an appropriate criterion (OGTT) in the diagnosis and assessment of patients with schizophrenia, as the results emphasize this relationship. Also, a significant relationship was noted between OGTT and the number of relapses, but the relationship between the time of onset for the patient and the results of OGTT remains unclear. Nonetheless, OGTT can be used in everyday practice as early as the end of the initial period to anticipate a relapse of the disease.

OGTT is used to evaluate metabolic parameters in schizophrenia patients, and may be useful for the monitoring of therapeutic responses. It may be useful to add OGTT to treatment programs.

The course of schizophrenia is likely to be protracted and to vary significantly. One group of patients may respond well to a treatment regimen and relapse may not be a problem. Nevertheless, another group may respond to a regimen and relapse may be a problem or a possible relapse may occur. These two groups of patients may respond to the same treatment regimen, but respond differently to the same regimen. If there are no medical hazards, the treatment approach for both groups will be the treatment program. It is important to understand that at any one time, any patient who is treated well will be relapse-free and the patient who is not treated well is likely to relapse.

Findings from a recent study indicated that a negative OGTT could be a sign of glucose homeostasis disruption, but if they have abnormal biochemical analyses or repeated OGTT in the future, it should be considered that they may have other psychiatric conditions.