Medication

This research aims to evaluate whether taking antipsychotic medication every other day is as effective as the usual daily dosing for people with schizophrenia or related disorders. The study also explores if the alternate day dosing reduces side effects compared to daily treatment. It is a randomized, double-blind trial designed to compare these two dosing schedules over one year. Participants will be randomly assigned to either continue their current daily antipsychotic medication risperidone, olanzapine, or paliperidone or switch to an alternate day dosing schedule. To maintain blinding, active medication and placebo capsules are provided in matching blister packs so participants and staff cannot tell which regimen is assigned. Doses range from 1 mg to 16 mg for risperidone, 5 mg to 20 mg for olanzapine, and 3 mg to 12 mg for paliperidone. Treatment is individualized, and other psychotropic medications can continue if stable. Participants will attend 22 visits over 52 weeks, with visits every two weeks for the first six months and monthly visits for the final six months. Researchers will assess symptom severity and side effects using several scales, including the Brief Psychiatric Rating Scale and multiple symptom and wellbeing questionnaires. The main outcome focuses on clinical deterioration at the start and end of the study. Safety and medication adherence will be closely monitored throughout the trial.

Researchers are comparing two pharmacokinetic models, Eleveld and Schnider, for administering propofol sedation in mechanically ventilated patients in the intensive care unit ICU. This observational study aims to assess which model better controls sedation depth, maintains hemodynamic stability, and supports faster recovery. The study uses sedation scales and monitoring tools like the Bispectral Index BIS and Riker Sedation-Agitation Scale to evaluate patient responses and safety. Participants will receive propofol through a target-controlled infusion TCI system guided by either the Eleveld or Schnider model. Sedation will be adjusted to maintain a Riker score between 3 and 4 and a BIS value between 60 and 80. Researchers will record hemodynamic variables, total propofol dosage, awakening time, and incidence of delirium after sedation withdrawal. No other sedatives or hypnotics will be used during sedation. During the study, patients will be monitored for sedation accuracy using BIS values for up to 72 hours. Assessments will include the proportion of time patients remain within the target sedation range. Data such as medical history, laboratory tests, and sedation depth will be collected and analyzed. The study will help identify the most reliable model for safe and effective sedation in ICU settings, with continuous monitoring of patient safety and sedation effects throughout the sedation period.

Researchers are evaluating the safety and effectiveness of two sedation combinations, ketamine-propofol and dexmedetomidine-propofol, in children aged 2 to 12 undergoing cardiac catheterization to close simple left-to-right heart shunts. This phase 1 clinical trial focuses on pediatric patients having elective transcatheter device closure procedures for defects such as atrial septal defect, ventricular septal defect, or patent ductus arteriosus. Participants will be randomly assigned to receive one of two sedation regimens during their procedure. One group will receive an initial IV bolus of ketamine followed by a propofol infusion, while the other group will receive a dexmedetomidine loading dose and propofol infusion. Both treatments allow additional propofol doses if sedation is inadequate. The study monitors sedation during the procedure guided by echocardiography. Throughout the trial, children will be closely monitored for respiratory complications, heart rate, blood pressure, sedation quality, and recovery time within two hours after sedation. Safety and sedation levels will be assessed continuously to compare the two sedation methods. Participation involves the procedure and related assessments, with follow-up monitoring conducted during and shortly after the intervention.

Researchers are studying the effects of Huperzine A Injection on reducing postoperative delirium in elderly patients aged 75 and older who are undergoing non-cardiac surgery. This randomized, double-blinded, placebo-controlled trial aims to observe how this treatment may influence the occurrence of delirium after surgery in this older population. Participants will be randomly assigned to receive either Huperzine A Injection or a placebo of 0.9% Sodium Chloride Injection during their non-cardiac surgical procedure. The study includes patients with an anesthesia grade of III to IV and an estimated operation time of at least 2 hours. The treatments will be administered under controlled conditions to carefully assess their effects on postoperative delirium. During the study, participants will be monitored for delirium incidence within 7 days after surgery, with additional evaluations at 24, 48, and 72 hours post-operation. Researchers will also assess the type, severity, and duration of delirium, length of hospital stay, economic costs, complications, mortality rates, and cognitive function using the Mini-mental State Examination and EuroQol scale. Follow-up assessments will continue up to 2 months after surgery, with some evaluations occurring around 30 days after discharge.

Researchers are investigating how acute preoperative pain affects the development of chronic postsurgical pain CPSP in patients undergoing emergency orthopaedic or abdominal surgery. Unlike scheduled surgeries where preoperative pain lasts weeks or months, emergency surgery involves intense but short-term pain. This study aims to clarify the long-term impact of this acute pain on CPSP occurrence three months after surgery. Participants will be asked to complete a questionnaire 48 to 72 hours after surgery to share their pain experience and preoperative anxiety. Then, three months post-surgery, researchers will conduct a phone interview using a standardized questionnaire to assess the presence of chronic postsurgical pain. This approach allows evaluation of pain progression from acute to chronic phases following emergency surgery. During the study, patients pain perception and anxiety levels shortly after surgery will be recorded, followed by a longer-term follow-up assessing the frequency of CPSP. The main measure is the occurrence of CPSP at three months. Participation involves questionnaires and phone interviews without additional treatments. The study is sponsored by Centre Hospitalier Universitaire, Amiens and is open to adults aged 18 and older undergoing emergency surgery.

This research aims to evaluate the added effect of Amantadine or Duloxetine when combined with Pregabalin on the development of post mastectomy pain syndrome PMPS, a common chronic pain condition occurring after breast surgery. PMPS affects 20% to 50% of patients and is a type of chronic post-surgical pain. The study investigates how these medications might influence pain pathways and nerve excitability in patients undergoing modified radical mastectomy for breast cancer. Participants are assigned randomly to one of three groups. Two hours before surgery, one group receives Pregabalin 75 mg with a placebo tablet another group receives Pregabalin 75 mg plus Amantadine 100 mg and the third group receives Pregabalin 75 mg plus Duloxetine 30 mg. All treatments are continued twice daily for seven days after surgery. This double-blind study compares the effect of these treatments on pain development following mastectomy. During the study, researchers will monitor the occurrence of post mastectomy pain syndrome 12 weeks after surgery as the primary outcome. Secondary outcomes include patient quality of life, activity level, pain severity at 12 weeks, and opioid use during and after surgery. Side effects related to each medication are tracked for 48 hours post-procedure. Participants are evaluated through clinical assessments and medication monitoring over the course of the treatment and follow-up period.

Hypertension is a major cause of cardiovascular disease and death, and many patients have uncontrolled blood pressure often due to not taking medications as prescribed. This research aims to study if testing urine for antihypertensive drugs can better detect medication non-adherence in patients with hypertension, including those who recently had a stroke. The study will evaluate whether identifying non-adherence and providing targeted counseling can improve medication use and blood pressure control. The study has three parts first, reviewing urine samples from 200 patients who recently had a stroke to check medication adherence second, enrolling 100 patients with poorly controlled hypertension to assess adherence prospectively and third, counseling participants found to be non-adherent and reassessing them at 3 and 6 months. Urine samples of 50ml will be collected during visits for mass spectrometry analysis to detect medication levels. Participants will attend study visits at enrollment, 3 months, and 6 months, providing urine samples each time. Researchers will measure changes in medication adherence rates and blood pressure, including systolic and diastolic values, over 6 months. The study aims to improve adherence and blood pressure control, potentially reducing healthcare visits and serious cardiovascular events.

This research aims to assess whether a human coach-supported digital and AI personal health assistant app can help improve how well patients with hyperlipidemia stick to their cholesterol-lowering medication plans compared to standard care. Hyperlipidemia is a major risk factor for heart attacks, and poor medication adherence leads to worse health outcomes and increased burden on individuals and health systems. The study is a multicenter, open-label, randomized controlled trial enrolling patients who are not fully following their statin medication regimens and have LDL cholesterol above recommended levels. Participants will be randomly assigned to one of two groups one receiving usual standard care for lipid management, and the other receiving the digitalAI health assistant app plus human coaching in addition to standard care. The intervention includes personalized feedback and educational content via the app along with six human coaching sessions over six months, designed to support medication adherence and general well-being. The coaching focuses strictly on adherence and does not involve medication changes, although concerns are escalated to pharmacists when needed. Participants will be followed for one year with visits at 3, 6, and 12 months to collect pill counts and clinical data. Clinical pharmacists will monitor and adjust medications as required as part of standard care. The study will evaluate adherence effectiveness at 6 and 12 months, along with secondary outcomes like LDL cholesterol levels, cardiovascular risk scores, health motivation, self-care behaviors, quality of life, and safety and acceptability of the new care model. A sub-study will collect patient insights on using the app and coaching to improve future interventions.

Phacoemulsification is a common cataract surgery performed under topical anesthesia, which is generally safe but can cause pain, anxiety, and discomfort for some patients. This research evaluates the effect of oral anti-anxiety medication, specifically Alprazolam, on improving patient satisfaction during second eye cataract surgery. The study aims to clarify whether oral sedation can reduce pain, anxiety, and side effects like nausea and dizziness compared to no sedation during phacoemulsification. Patients will receive either a single oral dose of Alprazolam or a placebo tablet 30 minutes before surgery. The dose of Alprazolam is 0.5 mg for most patients, with a reduced 0.25 mg dose for those over 65 years or with liver disease. The study compares these groups to assess how oral sedation affects anxiety, pain, and surgical satisfaction. This is an extension study involving patients undergoing surgery on their second eye with topical anesthesia. During the trial, participants will complete questionnaires assessing pain, anxiety, and overall satisfaction before and after surgery. Researchers will monitor intraoperative discomfort and postoperative anxiety levels. Data from approximately 250 patients will be collected and analyzed for these outcomes. This study runs from March 2025 to December 2027, focusing on improving cataract surgery experiences safely and conveniently.

Researchers are evaluating the effects of four different anesthetic maintenance methods on surgical conditions, blood pressure stability, and brain protection during functional endoscopic sinus surgery FESS performed with controlled low blood pressure. The study compares propofol-remifentanil alone, propofol-remifentanil with added ketamine and magnesium, sevoflurane-remifentanil alone, and sevoflurane-remifentanil with added ketamine and magnesium. The main focus is on measuring blood markers of brain injury and assessing the quality of the surgical field and bleeding during surgery. Participants are randomly assigned to one of the four groups receiving general anesthesia with either propofol-remifentanil or sevoflurane-remifentanil, with or without continuous infusions of ketamine and magnesium. The infusions are administered continuously during surgery according to the assigned group. This trial is conducted at a single center and includes a triple-blind design to reduce bias. During the study, participants will have blood samples taken at three key times before surgery starts, 20 minutes after controlled low blood pressure begins, and at surgery end to measure brain injury markers. Surgeons will rate surgical field visibility and bleeding at the end of surgery. Recovery will be assessed immediately after extubation using standard scores, and postoperative pain will be measured within 24 hours. The total participation involves the surgery and immediate postoperative period, with ongoing monitoring of outcomes related to anesthesia methods and brain protection.