Am J Psychiatry 164:670-673, April 2007
doi: 10.1176/appi.ajp.164.4.670
© 2007 American Psychiatric Association
The Effects of an Indigenous Muscarinic Drug, Betel Nut (Areca catechu), on the Symptoms of Schizophrenia: A Longitudinal Study in Palau, Micronesia
Roger J. Sullivan, Ph.D.,
Sylvia Andres, D.Ch.M.S., P.G.Dip.M.H.,
Caleb Otto, M.B.B.S.,
Wayne Miles, M.B.Ch.B., M.D., and
Robert Kydd, M.B.Ch.B., Ph.D.
OBJECTIVE: This study tested the findings of a prior study indicating a therapeutic relationship between consumption of betel nut and symptoms of schizophrenia. METHOD: The subjects were 65 outpatients with diagnoses of schizophrenia or schizoaffective disorder. Symptoms rated with the Positive and Negative Syndrome Scale were compared between high- and low-consumption betel chewers in a repeated-measures design. Movement disorders were assessed with the Abnormal Involuntary Movement Scale and Simpson-Angus Rating Scale. Global health and social functioning were assessed with the Medical Outcomes Study 12-item and 36-item Short-Form Health Surveys, respectively. RESULTS: Male high-consumption betel chewers had significantly milder positive symptoms than low-consumption chewers over 1 year. Betel chewing was not associated with global health, social functioning, or movement disorders. Betel chewing was associated with tobacco use but not with cannabis or alcohol. CONCLUSIONS: These findings have clinical significance in betel-chewing regions and broader implications for theory of muscarinic neurophysiology in schizophrenia.
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