Tardive dyskinesia is an insidious and debilitating extrapyramidal side effect of neuroleptic drug treatment. Recent research has suggested that lecithin has been effective in treating tardive dyskinesia. Lecithin's effects were evaluated under double-blind placebo controlled conditions. Treatment conditions included a placebo control group, a lecithin treatment group, and a no-treatment control group. Subjects in the lecithin group received 60 gms/day of lecithin (33 gms of phosphatidylcholine) . Subjects in the placebo group received a similar mixture which contained no lecithin. Subjects received mixtures for 9-11 days. Treatment effectiveness was determined by subjective, objective, and global evaluations. All subjects were evaluated 3 to 4 days prior to treatment and following 9 to 11 days of treatment.

Made available in DSpace on 2016-08-19T17:47:13Z (GMT). No. of bitstreams: 1 Dissertacao Bruno Araujo Serra Pinto.pdf: 525434 bytes, checksum: f28f41d2b195ef8e5e8e0050b3d3fc75 (MD5) Previous issue date: 2011-10-31 / FUNDAÇÃO DE AMPARO À PESQUISA E AO DESENVOLVIMENTO CIENTIFICO E TECNOLÓGICO DO MARANHÃO / Himatanthus drasticus Mart. popularly known as janauba, is so widely used medicinally as antitumor, antiulcer and analgesic. Pharmacological studies carried out previously found antiulcerogenic, anti-inflammatory, analgesic and antitumor actions of crude extract and isolated compounds of the species. This study investigated psychopharmacologicals effects of acute administration of hydroalcoholic extract (EHA) from the barks of Himatanthus drasticus in mice. Initially, we performed a pharmacological behavioral screening to investigate potential changes induced by EHA. Swiss male mice were treated with EHA (10, 30 and 100 mg/kg) or vehicle (0.9% saline) 30 min (ip) before experiments. Were observed sedative and neuroleptic effects of the extract in a dose dependent. The EHA showed low toxicity with DL50 of 3.4 g/kg. Because of the potent sedative effect appears even at low doses, the study was directed to perform tests related to a central nervous system depressant, such as hypnosedated, anticonvulsant and neuroleptic tests. To this end, potentiation of barbiturate-induced sleep, induction of catalepsy and induction of seizures with pentilenoteteazol (PTZ) and strychnine (STR) were chosen. Significant effects were observed potentiation of hypnosis and state of catatonia with all doses of EHA gradually. There were no decreases in seizure parameters of the treated animals in testing for strychnine convulsions, thus excluding the involvement of glycine mechanisms mimetics. In the test of PTZ-induced seizures, the EHA showed a significant anticonvulsant activity and bioprotector in all parameters evaluated and at all doses tested in a manner very similar to the positive control (diazepam), suggesting an involvement of the EHA-level gabaergics receptors, explaining satisfactorily the sedative and anticonvulsant presented. With that, this test was chosen to evaluate the alkaloids total fraction (FAT) at doses of 3 and 10 mg/kg, but the FAT did not have results significant as the EHA, suggesting that the effects of the extract are related to other secondary metabolites or fitocomplex. Our results demonstrate for the first time, anticonvulsant, neuroleptic and hypnosedated actions of H. drasticus extact, guiding future work aimed at elucidating the mechanisms by which these effects are mediated. / Himatanthus drasticus Mart. popularmente conhecida como janaúba, é amplamente utilizada de forma medicinal como antitumoral, antiulcerogênica e analgésica. Estudos farmacológicos anteriormente realizados constataram ação antiulcerogênica, antiinflamatória, analgésica e antitumoral do extrato bruto e compostos isolados da espécie. Este trabalho investigou os efeitos psicofarmacológicos da adminsitração aguda do extrato hidroalcoólico (EHA) das cascas de Himatanthus drasticus em camundongos. Inicialmente, foi realizada uma triagem farmacológica comportamental para a investigação de possíveis alterações induzidas pelo EHA. Camundongos swiss machos foram tratados com EHA (10, 30 e 100 mg/kg) ou veículo (salina a 0,9%) 30 min (i.p.) antes dos experimentos. Foram observados efeitos sedativos e neurolépticos do extrato nas doses utilizadas de forma dose dependente. O EHA apresentou baixa toxicidade com DL50 de 3,4 g/kg. Em virtude do potente efeito sedativo apresentado, mesmo em baixas doses, o estudo foi direcionado para realização de testes relacionados á uma depressora do sistema nervoso central, como testes de atividade hipnosedativa, anticonvulsivante e neuroléptica. Para este fim foram escolhidos os testes de potencialização do sono induzido por barbitúricos, indução de catalepsia e indução de convulsões com pentilenoteteazol (PTZ) e estricnina (STR). Foram observados significantes efeitos de potencialização da hipnose e do estado de catatonia com todas as doses do EHA de forma progressiva. Não foram observadas diminuições dos parâmetros convulsivos dos animais tratados no teste de convulsões pela estricnina, excluindo assim o envolvimento de mecanismos miméticos da glicina. No teste de convulsões induzidas pelo PTZ, o EHA apresentou significante atividade anticonvulsivante e bioprotetora em todos os parâmetros avaliados e em todas as doses testadas de forma bem semelhante ao controle positivo (diazepam), sugerindo uma participação do EHA em nível de receptores gabaérgicos, explicando de forma satisfatória os efeitos sedativos e anticonvulsivantes apresentados. Com isto, este teste foi escolhido para avaliação da fração de alcalóides totais (FAT) nas doses de 3 e 10 mg/kg, no entanto a FAT não apresentou resultados tão significativos quanto o EHA, sugerindo que os efeitos do extrato estejam relacionados a outros metabólitos secundários ou ao fitocomplexo. Nossos resultados demonstram pela primeira vez, ação anticonvulsivante, neuroléptica e hipnosedativa do EHA de H. drasticus, norteando trabalhos futuros que visem elucidar os mecanismos pelos quais estes efeitos são mediados.

Made available in DSpace on 2015-04-01T12:09:01Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 2989827 bytes, checksum: 945befc988b64a6065402f74eb5edcf9 (MD5) Previous issue date: 2013-10-30 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / (-)-myrtenol (MYR) is a monoterpene found in various aromatic plants. However, te scientific literature has not yet described any psychopharmacological properties of this molecule. This study aimed to investigate the influence of myrtenol on the central nervous system of male Swiss mice and Wistar rats checking their anxiolytic, neuroleptic and anticonvulsant activities, in addition to its antioxidant and toxic potentials. Anxiolytic assays were performed using the elevated plus maze test (EPM) and light-dark transition test (LDT), besides the open field test (OFT) and Rota Rod test to assess the effects on the locomotor system of these animals. The neuroleptic activity was checked by the test of catalepsy induced by haloperidol (HAL). The anticonvulsant effect was analyzed by seizures induced by pentylenetetrazol (PTZ), picrotoxin (PIC) and pilocarpine (P). To check the potential toxicity hippocratic screening was performed, by assessment of body weight, food consumption and production of excreta, the hematological and biochemical parameters, as well as macroscopic and histopathological organs of experimental animals. Additionally, was studied the antioxidant profile the study on the antioxidant profile, through in vitro (TBARS, removal of nitrite and hydroxyl radical) and in vivo techniques [lipid peroxidation, nitrite production and activity of catalase (CAT), superoxide dismutase (SOD) and reduced glutathione (GSH)]. In EPM, myrtenol administration significantly increased the input numbers (MYR=5.6; Control=3.1) and time spent by the animals in the open arms (MYR=106.8s; Control=47.5s) when compared with the control group and in the LDT myrtenol increased significantly the time spent by animals in the light compartment (MYR=187.4s; Control=105.1s). In OFL and Rota Rod test, the results revealed no significant changes in the parameters observed. In seizures induced, the results revealed that the myrtenol increased the latency to the first seizure [P(MYR=21.5s; Control=11.9s); PTZ(MYR=280.4s; Control=87.3s); PIC(MYR=696.0s; Control=522.4s)] and decreased the percentage of seizures [P(MYR=53.3%;); PTZ(MYR=37.3%); PIC(MYR=33.3%)], as well as the percentage of deaths of animals [P(MYR=53.3%); PTZ(MYR=48.3%); PIC(MYR=33.3%)]. The test of catatonia showed a significant reduction in the time spent in the antiphysiologic position (MYR=0.9s; HAL=29.7s). On the toxicity studies, the hippocratic screening showed good tolerability of myrtenol and no significant changes in dietary patterns, production of excreta, body weight, hematological and biochemical parameters and morphological or histopathological findings. About the antioxidant potential, myrtenol reduced lipid peroxidation (MYR=86.8%; VitC=56%), level of nitrite (MYR=85.3%; VitC=24.5%) and increased antioxidants enzymes activity [CAT(MYR=102.3%; SOD (MYR=39.5%); GSH(MYR=12.2%)] in treated animals. In conclusion, myrtenol has anxiolytic potential without sedative effect, possesses neuroleptic, anticonvulsant and antioxidant activities, with low toxicity and can be considered a potential bioproduct in formulation of phytomedicine. / O (-)-mirtenol (MIR) é um monoterpeno encontrado em diversas plantas aromáticas. Entretanto, ainda não foram descritas na literatura suas propriedades psicofarmacológicas. Nesse sentido, este estudo teve como objetivo investigar a influência do mirtenol sobre o sistema nervoso central de camundongos Swiss e ratos Wistar para verificar seu efeito ansiolítico, neuroléptico e anticonvulsivante, além do potencial antioxidante e tóxico. Foram realizados ensaios ansiolíticos utilizando-se os testes do labirinto em cruz elevado (TLCE) e de transição claro-escuro (TTCE), além dos testes do campo aberto (TCA) e Rota Rod para avaliar os efeitos sobre o sistema locomotor desses animais. O efeito anticonvulsivante foi analisado pelos testes de convulsão induzida por pentilenotetrazol (PTZ), picrotoxina (PIC) e pilocarpina (P) e o neuroléptico pelo teste de catalepsia induzida por haloperidol (HAL). Para verificar o potencial tóxico realizou-se screening hipocrático, avaliação da massa corporal, consumo alimentar e produção de excretas, análise dos parâmetros hematológicos e bioquímicos e avaliação morfológica macroscópica e histopatológica de órgãos dos animais experimentais. Adicionalmente, estudou-se o perfil antioxidante, através das metodologias in vitro (TBARS, remoção do radical nitrito e hidroxila) e in vivo [lipoperoxidação, produção de nitrito e atividade das enzimas catalase (CAT), superóxido dismutase (SOD) e glutationa reduzida (GSH)]. No TLCE, o mirtenol aumentou significativamente o número de entradas (MIR=5,6; Controle=3,1) e o tempo de permanência dos animais nos braços abertos (MIR=106,8s; Controle=47,5s) e, no TTCE, aumentou significativamente o tempo de permanência dos animais no compartimento claro (MIR=187,4s; Controle=105,1s). No TCA e Teste do Rota Rod, não houve alterações significativas dos parâmetros observados. Nos testes sobre convulsão, o mirtenol aumentou a latência para a primeira convulsão [P(MIR=21,5s; Controle=11,9s); PTZ(MIR=280,4s; Controle=87,3s); PIC(MIR=696,0s; Controle=522,4s)] e diminuiu a porcentagem destas [P(MIR=53,3%;); PTZ(MIR=37,3%); PIC(MIR=33,3%)], assim como o percentual de mortes dos animais [P(MIR=53,3%); PTZ(MIR=48,3%); PIC(MIR=33,3%)]. No teste da catatonia o mirtenol reduziu significativamente o tempo de permanência dos animais na posição antifisiológica induzida (MIR=0,9s; HAL=29,7s). Na avaliação da toxicidade, o screening hipocrático revelou boa tolerabilidade do mirtenol e não houve alterações significativas no padrão alimentar, produção de excretas, massa corporal, parâmetros hematológicos, bioquímicos, morfológicos ou histopatológicos. Quanto ao potencial antioxidante, o mirtenol reduziu a lipoperoxidação (MIR=86,8%; VitC=56%), o teor de nitrito (MIR=85,3%; VitC=24,5%) e aumentou a atividade das enzimas antioxidantes nos animais tratados [CAT(MIR=102,3%; SOD (MIR=39,5%); GSH(MIR=12,2%)]. Conclui-se que o mirtenol apresenta potencial ansiolítico sem efeito sedativo, atividade neuroléptica, anticonvulsivante e antioxidante, com baixa toxicidade, podendo ser considerado potencial bioproduto na formulação de fitomedicamentos.

No / The use of neuroleptic drugs to mediate the behaviour of people with dementia living in care homes can lead to them being deprived of their liberty. Whilst regulation has been successful in reducing neuroleptic prescribing in the USA, policy guidance has been unsuccessful in reducing the use of these drugs in the UK. Yet the Mental capacity act 2005 aimed to protect the liberty of people lacking capacity and provided safeguards to ensure that they are not inappropriately deprived of their liberty in institutions. This article highlights the potential for using this law to identify when neuroleptic prescribing in care homes would deprive people with dementia of their liberty and, in turn, to act as a check on prescribing levels. However, the extent to which the Act can promote and protect the right to liberty of people with dementia is constrained by a lack of access to social rights.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Haloperidol and fluphenazine are typical neuroleptics widely used in the treatment of mental illness, whose chronic use is associated with adverse effects that affect the motor function and memory, among others. The motor disturbances can be moderate, and include parkinsonism, akathisia, dystonia, but also a more severe syndrome, known as tardive dyskinesia (TD). Studies have shown that essential polyunsaturated fatty acids (EPUFAs) may affect physiological functions involved in movement and memory disorders through of the membrane phospholipid composition of neuronal cells. This study investigated the effects of supplementation of EPUFA (omega-3) on orofacial dyskinesia and memory dysfunction induced by haloperidol and fluphenazine, designated as experiment 1 and 2, respectively. In both experiments, male Wistar rats received in place of drinking water, a suspension with capsules of fish oil (FO), whose composition was determined by gas chromatography (EPA-20%, DHA- 6%, linolenic acid- 0, 4%), or vehicle (C). After 8 weeks of treatment, half the animals of each experimental group received a weekly administration of neuroleptic (12mg/kg/mL-im) (H-haloperidol or F-fluphenazine in experiments 1 and 2, respectively) or vehicle for 4 weeks. The intake of omega-3 ad libitum in the drinking water was maintained during this time. The animals were observed weekly for the quantification of orofacial dyskinesia (OD), (vacuous chewing movements frequency- VCM) in 7th, 14th, 21st and 28th days after the first dose of neuroleptic/vehicle. Immediately after each orofacial observation, the rats treated with neuroleptic (H and FO+H, experiment 1, F and FO+F, experiment 2) were submitted to catalepsy-time quantifications. In the last week of treatment, the rats of both experiments were previously trained for 4 consecutive days and submitted to memory test in water-maze task. On the 8th day after the last dose of neuroleptic/vehicle, the rats were sacrificed by exsanguinations (by cardiac puncture), with blood collection and removal of brain tissue (hippocampus and substantia nigra) for determination of lipid peroxidation. Data of OD (VCMs) and catalepsy time were analyzed by three-way and one way ANOVA with repeated measure, respectively, followed by Duncan s test (VCMs only) and paired T test; Data of water-maze task and assessments of lipid peroxidation (TBARs) were evaluated by two way ANOVA followed by Duncan s test. Statistical significances were considered for P <0.05 values for all assessments. The omega-3 decreased the motor disorders (VCMs and catalepsy time), the loss of memory and parameters of lipid peroxidation induced by neuroleptics, suggesting that these effects are related to the anti-apoptotic properties of EPUFAs. Our results emphasize the importance of including fatty acids n-3 from diet or its supplementation, which may prevent or reduce motor and memory disorders, often related to chronic treatment with typical neuroleptics, which until now has no effective treatment. / Neurolépticos típicos como haloperidol e flufenazina são amplamente empregados no tratamento das doenças mentais, cujo uso crônico está associado a efeitos adversos que afetam as funções motoras e de memória, entre outras. Os distúrbios motores podem ser mais brandos, e incluem tremores, acatisia, distonias, como também uma síndrome mais grave, a discinesia tardia (DT). Estudos têm demonstrado que os ácidos graxos poliinsaturados (AGPIs) podem afetar as funções fisiológicas envolvidas nos distúrbios do movimento e de memória, através da composição da membrana fosfolipídica das células neuronais. O objetivo deste estudo foi investigar os efeitos da suplementação dos AGPIs n-3 (ômega-3) sobre a discinesia orofacial e a disfunção de memória induzidas por haloperidol e flufenazina, designados como experimento 1 e 2, respectivamente. Em ambos os experimentos, ratos Wistar machos receberam no lugar da água de beber, uma suspensão com cápsulas de óleo de peixe (OP), cuja composição foi determinada através de cromatografia gasosa (EPA-20%, DHA 6%, ácido linolênico 0,4%), ou veículo (C). Após 8 semanas de tratamento, metade dos animais de cada grupo experimental receberam uma administração semanal de neuroléptico (12 mg/kg/mL;im) (H-haloperidol e F-flufenazina, nos experimentos 1 e 2 respectivamente) ou veículo por 4 semanas. Durante este tratamento a ingestão ad libitum de ômega-3 na água de beber foi mantida. Os animais foram semanalmente observados para a quantificação da discinesia orofacial (DO) (incidência de movimentos de mascar no vazio - VCM) no 7º, 14º, 21º e 28º dias após a primeira administração de neuroléptico ou veículo. Logo após cada observação orofacial, todos os animais tratados com neurolépticos (grupos H e OP+H, experimento 1; F e OP+F, experimento 2) foram submetidos à quantificação do tempo de catalepsia. Na última semana de tratamento, de ambos os experimentos foram submetidos ao teste de memória em water-maze , após 4 dias de treinamento. No 8º dia após a última administração de neuroléptico/veículo, os ratos foram sacrificados por exsanguínação (punção cardíaca), com coleta de sangue e retirada de tecidos cerebrais (substância-negra e hipocampo) para determinação de parâmetros de peroxidação lipídica. Os dados da DO (VCMs) foram analisados por ANOVA de três vias com medida repetida, seguida por teste de Duncan e teste T pareado; O tempo de catalepsia foi avaliado por ANOVA de uma via com medida repetida, seguida de teste T pareado; Resultados obtidos em paradigma de labirinto aquático e avaliações de peroxidação lipídica (TBARS) foram avaliados por ANOVA de duas vias seguida de teste de Duncan. Foram considerados significativos os valores de P<0.05, para todas as avaliações. O ômega-3 diminuiu as desordens motoras (VCM e tempo de catalepsia), os prejuízos de memória e parâmetros de peroxidação lipídica induzidos pelos neurolépticos, sugerindo que esses efeitos estão relacionados com as propriedades anti-apoptóticas dos ácidos graxos essenciais. Nossos resultados ressaltam a importância da inclusão de ácidos graxos n-3s na dieta ou através da sua suplemantação, os quais podem prevenir ou atenuar distúrbios motores e de memória, freqüentemente relacionados ao tratamento crônico com neurolépticos típicos, que até o momento não dispõe de um tratamento eficaz.

There is an increase in the prevalence of obesity among people with schizophrenia thought to be due in part to the weight enhancing side-effects of medications commonly used to treat the symptoms of schizophrenia. Despite the deleterious health effects associated with obesity and its impact on quality of life and medication compliance, little is known about body composition and energy expenditure in this clinical group. The primary purpose of this thesis was to enhance understanding of body composition and energy expenditure, particularly resting energy expenditure in men with schizophrenia who take atypical antipsychotic medications. Unique to this investigation is the evaluation of clinical tools used to predict body composition and energy expenditure against reference methodologies in men with schizophrenia. Further, given the known links between obesity and physical activity, an additional but less comprehensive component of the thesis was a consideration of total and activity energy expenditure in addition to the interaction between psychiatric symptoms, side-effects of antipsychotic medications and physical activity also occurred as part of this thesis. Collectively, the goals of this thesis were addressed through a series of studies – the first two studies were related to the measurement and characteristics of body composition in men with schizophrenia, while the third and fourth studies were related to the measurement and characteristics of resting energy expenditure in men with schizophrenia. The fifth and sixth studies the utilised doubly labelled water technique to quantify activity and total energy expenditure in a small group of men with schizophrenia and explored the use of accelerometry in this cohort. The final study briefly considered the impact of psychiatric symptoms and self-reported medication side-effects on objectively measured physical activity. In the first study, thirty-one male adults previously diagnosed with schizophrenia and sixteen healthy male controls were recruited. Estimates of body composition derived from an anthropometry-based equation and from bioelectric impedance analysis (BIA) using deuterium dilution as the reference methodology to determine total body water were compared. The study also determined the validity of equations commonly used to predict body composition from BIA in the men with schizophrenia. A further aim was to determine the superiority of either BIA or body mass index (BMI) as an indicator of obesity in this cohort. The inclusion of the control group, closely matched for age, body size and body composition demonstrated that there was no difference in the ability of body composition prediction methods to distinguish between fat and fat-free mass (FFM) in controls and men with schizophrenia when both groups had similar body composition. However this study indicated that an anthropometry-based equation previously used in people with schizophrenia was a poor predictor of body composition in this cohort, as evidenced by wide limits of agreement (25%) and systematic variation of the bias. In comparison, the best predictor of percentage body fat (%BF) in this group was gained when impedance values were used to predict percentage body fat via the equation published by Lukaski et al (1986). Although percentage body fat was underpredicted using the Lukaski et al. (1986) equation, the mean magnitude was relatively small (1.3%), with the limits of agreement approximately 13%. Linear regression analysis revealed that %BF predicted using the Lukaski et al. (1986) equation explained 25% more of the variance in percentage body fat than BMI. Further, this study also indicated that BIA was more sensitive than BMI in distinguishing between overweight and obesity in this cohort of men with schizophrenia. Because of the almost exclusive use of BMI as an indicator of obesity in people with schizophrenia, the level of excess body fat may be in excess of that previously indicated. The second study extended the examination of body composition in men with schizophrenia. In this study, the thirty-one participants with schizophrenia (age, 34.2 ± 5.7 years; BMI, 30.2 ± 5.7 kg/m2) were individually matched with sedentary controls by age, weight and BMI. Deuterium dilution was used to distinguish between FFM and fat mass. The previous study had indicated that while BIA was a suitable group measure for obesity, on an individual level the technique lacked the precision required for investigating body composition in men with schizophrenia. Waist circumference was used as an indicator of body fat distribution. The findings of this study indicated that in comparison with healthy sedentary controls of similar body size and age, men with schizophrenia had higher levels of body fat which was more centrally distributed. Percentage body fat was on average 4% higher and waist circumference, on average 5 cm greater in men with schizophrenia than the sedentary controls of the same age and BMI. Further, this study indicates that the use of BMI to predict body fat in men with schizophrenia will result in greater bias than when it is used to predict body fat in other sedentary men. Commonly used regression equations to predict energy requirements at rest are based on the relationships between weight and resting energy expenditure (REE) and in such equations, weight acts as a surrogate measure of FFM. The objectives of study three were to measure REE in a small group of men with schizophrenia who were taking the antipsychotic medication clozapine and to determine whether REE can be predicted with sufficient accuracy to substitute for the measurement of REE in the clinical and/or research settings. Body composition was determined using deuterium dilution and REE was measured using a Deltatrac Metabolic Cart via a ventilated hood. The male participants, (aged 28.0 ± 6.7 yrs, BMI 29.8 ± 6.8 kg/m2) were weight stable at the time of the study and had been taking clozapine for 20.5 ± 12.8 months, with doses of 450 ± 140 mg/day. Of the six prediction equations evaluated, the equation of Mifflin et al. (1990) with no systematic bias, the lowest bias and the lowest limits of agreement proved to be the most suitable equation to predict REE in this cohort. The overestimation of REE can be corrected for by deducting 160 kcal/day from the predicted REE value when using the Mifflin et al. (1990) equations. However, the magnitude of the error associated with the prediction of REE for an individual is 370 kcal/day. The findings of this study indicate that REE cannot be predicted with sufficient individual accuracy in men with schizophrenia, therefore it was necessary to measure rather than predict REE in subsequent studies. In the fourth study, indirect calorimetry (Deltatrac Metabolic Cart via ventilated hood) and deuterium dilution were used to accurately determine REE, respiratory quotient (RQ) and FFM in 31 men with schizophrenia and healthy sedentary controls individually matched for age and BMI. Data from this study indicated that gross REE was lower in men with schizophrenia than in healthy sedentary controls of a similar age and body size. However, there was no difference between the groups in REE when REE was adjusted for FFM using the mathematically correct method (analysis of covariance with FFM as the covariate). There was however a statistically and clinically significant difference in resting, fasted RQ between men with schizophrenia and controls, suggesting that RQ rather than REE may be an important correlate worthy of further investigation in men with schizophrenia who take antipsychotic medications. Studies five and six involved the application of the doubly labelled water (DLW) technique to accurately determine total energy expenditure (TEE) and activity energy expenditure (AEE) in a small group of men with schizophrenia who had been taking the atypical antipsychotic medication clozapine. The participants were those who took part in study three. The purpose of these studies was to assess the validity of a commercially available tri-axial accelerometer (RT3) for predicting free-living AEE and to investigate TEE and AEE in men with schizophrenia. There was poor agreement between AEE measured using DLW and AEE predicted using the RT3. However, using the RT3 to measure inactivity explained over two-thirds of the variance in AEE. This study found that the relationship between current AEE per kilogram of body weight and change from baseline weight in men taking clozapine was strong although not significant. The sedentary nature of the group of participants in this study was reflected in physical activity levels, (PAL, 1.39 ± 0.27), AEE (435 ±352 kcal/day) and TEE (2511 ± 606 kcal/day) that fell well short of values recommended by WHO (2000) for optimal health and to prevent weight gain. Given the increasing recognition of the importance of sedentary behaviour to weight gain in the general community, further examination of the unique contributing factors such as medication side effects and symptoms of mental illness to activity levels in this clinical group is warranted. The final study used accelerometry (RT3) to objectively measure activity in a group of 31 men with schizophrenia who had been taking atypical antipsychotic medications for more than four months. The purpose of this study was to explore the relationships between psychiatric symptomatology, side-effects of medication and physical activity. Accelerometry output was analysed to provide a measure of inactivity and moderate intensity activity (MIA). The well-validated and reliable standardised clinical interview, the Positive and Negative Syndrome Scale (PANSS) was used as a measure of psychiatric symptoms. Perceived side-effects of medication were assessed using the Liverpool University Neuroleptic Rating Side-Effects Scale (LUNSER). Surprisingly, there was no relationship reported between any measures of negative symptoms and physical inactivity. However, self-reported measures of medication side-effects relating to fatigue, sleepiness during the day and extrapyramidal symptoms explained 40% of the variance in inactivity. This study found significant relationships between some negative symptoms and moderate intensity activity. Despite the expectation that as symptoms of mental illness reduce, inactivity may diminish and moderate intensity activity will increase, it may not be surprising that in practice this is an overly simplistic view. It may be that measures of social functioning and possibly therefore cognition may be better predictors of physical activity than psychiatric symptomatology per se.