aspirin

According to the American Association of Poison Control Centers (AAPCC), 761 single exposures to the pharmaceutical warfarin were reported in 2021, accounting for more than 10 percent of anticoagulant cases. The cost and mortality caused by warfarin toxicity are very high and usually incurable and fatal. The most important action in the field of warfarin toxicity is to prevent its occurrence. To emphasize how warfarin toxicity occurs, a case is introduced in this regard. A 61-year-old man is found unconscious with a seizure on the street and transported to the hospital by Emergency Medical Services (EMS). In the emergency car, he received a diazepam injection for generalized seizures. His vital signs in the postictal state were as follows: blood pressure 82/44 mmHg, pulse rate 91 bpm, and oxygen saturation (SaO2) 93%. His past medical history includes an ischemic stroke and a myocardial infarction 12 years ago. He underwent Mitral valve repair 11 years ago and a mechanical-type Mitral valve replacement 2 years ago. After undergoing mitral valve replacement surgery, he continued taking warfarin and aspirin for 2 years without consulting a cardiologist or undergoing PT and INR tests. As a result, he suffered a massive intracerebral hemorrhage when his INR level rose above 6. It's important to note that he has no history of depression or suicide attempts. After experiencing decreased consciousness and seizures, he was quickly intubated. A brain CT scan revealed extensive evidence of intracerebral hemorrhage, and he was then transferred to the operating room for craniotomy. To manage the bleeding and because Prothrombin complex concentrate (PCC) was not available, the patient received two grams of fibrinogen, two units of Fresh Frozen Plasma (FFP), 10 mg of vitamin K, and one unit of Packed Red Blood Cells. Unfortunately, after a month-long stay in the ICU, the patient passed away as a result of Ventilator-associated pneumonia (VAP) and sepsis.

Anticoagulation is the cornerstone of preventing thrombosis. Following the aging of society and the greater use of anticoagulant drugs, we see more serious complications in this group. The reduced occurrence of significant bleeding represents a notable benefit of direct oral anticoagulants (DOACs) in comparison to vitamin K antagonists. However, the unavailability of Andexanet alfa and Idarucizumab complicates the management of bleeding associated with DOACs. This case describes a 69-year-old man who presented with massive gastrointestinal bleeding, hemorrhagic shock, and loss of conciseness. He has been taking apixaban 2.5 mg twice a day, aspirin 80 mg once a day, and diltiazem 60 mg three times daily. Bleeding was controlled through transfusion of two units of fresh frozen plasma, five units of packed cell, four units of platelet, and tranexamic acid injection. Although hemorrhagic shock was successfully managed, he unfortunately passed away after three weeks of hospitalization following Ventilator-associated pneumonia and sepsis. In this case, we discuss the importance of the drug interaction of apixaban, diltiazem, and aspirin.

Ischemic stroke can lead to cognitive impairment, and nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to slow down the progression of Alzheimer›s disease (AD). This study focused on rodent models to investigate the impact of ischemic stroke and the potential benefits of aspirin in reducing cognitive impairment.

The Morris water maze (MWM) was used to evaluate memory and learning in seven groups (N=63) of Wistar rats. Brain ischemia was induced in rat models through temporary blocking of both common carotid arteries and permanent blocking of the middle cerebral artery (MCA). Aspirin 20, 40, and 80 mg/kg IP was administered 30 minutes and 2 hours after stroke induction in both ischemic and non-ischemic rats. Injections were continued for seven consecutive days in these groups, and learning and memory were evaluated after the last injection.

Data analysis of the MWM test showed a significant increase in escape latency and swim path length to find the platform in the ischemic groups compared to control rats (P<0.005). Despite improvement in all experimental groups after intervention (P<0.001), the scores for spatial learning were significantly decreased by aspirin in no-ischemia+ASA groups compared to the control group (P<0.05). In the ischemia+ASA groups, aspirin at the dose of 20 mg/kg but not at the high dose (80 mg/kg) improved spatial learning compared to the control group.

Repeated treatments with aspirin may impair spatial learning and memory in normal rats, however, aspirin at a low dose of 20 mg/kg may improve learning impairment after ischemic stroke.

Underreporting of adverse drug reactions (ADRs) due to time constraints, limited awareness, reluctance, and legal fears demands integrating pharmacists with physicians and implementing an extensive continuing education module on pharmacovigilance for application-based learning. Our study aimed to integrate a pharmacist with a treating physician to enhance patient safety by facilitating ADR reporting, providing a continuing education module on pharmacovigilance to senior residents and interns, and providing an ADR alert card to patients. We carried out a cross-sectional study over ten months in the general medicine department of a tertiary care hospital. We integrated Doctor of Pharmacy intern students with treating physicians to facilitate easy identification of ADR and for issuing ADR alert cards. We provided a seven-day continuing education module on pharmacovigilance concepts for senior residents and final-year medical interns. We distributed an ADR alert card to 180 patients. The largest groups of patients affected by ADRs in our study were aged between 41-50 and 51-60 years, collectively accounting for nearly 50% of the affected population. Our study reported a slight female predominance (51.1%). The gastrointestinal system (31.1%), nervous system (20%), and skin and subcutaneous tissue (13.9%) were the most frequently affected organ systems, accounting for 65% of the ADRs. Most ADRs (92.2%) were not serious. Analgesics (aspirin), HMG-CoA inhibitors (atorvastatin), and antiepileptics (phenytoin) were the top three drug classes most associated with ADRs. Out of 23 participants, 21 (91.3%) correctly completed the reporting of ADR into the ADR form from anonymous case reports, identified predisposing factors, assessed causality correctly, and suggested prevention and management strategies according to the clinical scenario. Most participants (95.7%) indicated that the module significantly enhanced their awareness and comprehension of Pharmacovigilance concepts, with only a small percentage (4.3%) expressing neutral sentiment and none disagreeing. Integrating pharmacists, continuing pharmacovigilance education, and issuing ADR alert cards significantly enhanced ADR reporting, comprehension of pharmacovigilance concepts, and patient safety measures in the healthcare setting.

This study aims to evaluate the effectiveness and safety of Aspirin and LMWH in an arthroscopic anterior cruciate ligament (ACL) reconstruction of low-risk patients. 

We conduct a single-center, assessor-blind, simple randomized clinical trial from March 2019- May 2020. 18 to 45 years old patients with ACL rupture without concomitant injury, diagnosed by magnetic resonance imaging, enrolled in the study. Selected subjects were allocated between three parallel arms of the study, with 46 participants. Three parallels are 8o mg aspirin bid for 14 days, LMWH subcutaneous injection for 14 days, and no treatment parallel. Effectiveness outcomes were estimated by the DVT rate and PE rate, and safety was checked out by bleeding or hemarthrosis. Orthopedists assessed knee effusion with stroke score and ask patients for any symptoms during weekly clinic visits. The radiologist performed ultrasonography of lower extremities, searching for a sign of DVT. 

Mean age of participants was 31.4 + 5.6, and 93 individuals (67%) were male and 23% were female. No DVT and PE were observed. Three cases in the LMWH and one case in aspirin groups had minor surgical site bleeding. One case of hemarthrosis with normal ultrasonography occurred in the LMWH group. Regarding safety and effectiveness, there was no statistically significant difference between the parallels. 

Use of LMWH or Aspirin after simple arthroscopic ACL reconstruction in low-risk patients have no different effectiveness. Hence routine use of thromboprophylaxis in this setting is questionable, although adverse events are rare.

 Previous studies have investigated the potential influence of prior aspirin use on cardiac function in patients with ST-elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (PPCI). However, the results from these studies have been conflicting. This study aimed to investigate whether prior aspirin use affects left ventricular (LV) function in these patients using echocardiography.

 The study included 260 consecutive STEMI patients, who were divided into two groups based on the presence or absence of prior aspirin use. Echocardiographic parameters, such as maximal left atrial (LA) size, LV ejection fraction (LVEF), early diastolic velocity (e’), E/A ratio, and E/e’ ratio, were assessed within 72 hours of admission.

 Aspirin users had an older age compared to non-users, as well as lower body mass index and renal function. They also had a greater history of hypertension and were more likely to be taking statins, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and calcium channel blockers. There were no significant differences in LVEF, maximal LA size, E/A ratio, E/e’ ratio, and deceleration time between aspirin users and non-users. e’ wave was marginally lower in aspirin users (P=0.054). After controlling for confounding variables, the previous use of aspirin did not show a significant impact.

 Prior aspirin use in STEMI patients does not have a significant impact on LV echocardiographic parameters. Our conclusions remained consistent even after adjusting for potential confounders.

Central serous chorioretinopathy (CSCR) is a common cause of central vision loss, primarily affecting men 20–60 years of age. This study aimed to investigate the efficacy of low-dose aspirin for the treatment of acute CSCR.

Totally 60 patients (60 eyes) with a history of acute CSC on fenofibrate were randomized into two groups: group A was treated with aspirin 100 mg per day orally for 1 month followed by 100 mg on alternate days for 5 months by evaluation of visual acuity, mean subretinal fluid vertical diameter (SFVD), Optical Coherence Tomography (OCT), and central macular thickness (CMT) at baseline and follow up period.  Group B received no medication and was considered as the control group. Follow-up times were the first week, 1, 2, 3 and 6 months after treatment initiation.

No differences were seen between the studied groups in terms of baseline BCVA (P = 0.968) and baseline SFVD (P = 0.774). BCVA improved, and SFVD was reduced significantly in the group A at all follow-up intervals compared with baseline values. Aspirin intervention (group A), compared with no intervention group (group B), was statistically more effective in improving BCVA (P < 0.001) and in reducing SFVD (P < 0.001) after 6 months. While 93.3% (n=28) of Group A’s cases had no recurrences during the follow-up period, only 60.0% (n=18) of patients in the group B had a resolution of CSCR with no recurrences.

More rapid visual rehabilitation with fewer recurrences of CSCR were detected in the group A than in group B. These results demonstrated that orally administered aspirin may be a promising option for selected patients in the treatment of acute CSCR.

Deep Vein Thrombosis (DVT) is a significant medical concern characterized by the formation of blood clots within the venous system. Surgical procedures are known to increase the risk of DVT. While enoxaparin has proven to be highly effective in treating DVT, co ncerns about bleeding and accurate dosage regulation may restrict its application. Recent research has focused on aspirin's potential in preventing DVT after various surgeries. This study aimed to determine whether aspirin was as effective as enoxaparin in preventing DVT after spine surgery. This randomized controlled trial enrolled study patients who underwent spine surgery at Shahid Kamyab Emergency Hospital in Mashhad, and had a Caprini score > 5, indicating a higher risk of DVT. In the control group, patients received subcutaneous injections of enoxaparin at a dosage of 40 mg, while the intervention group received oral aspirin tablets with a daily dosage of 81 mg. An experienced radiologist performed a Doppler ultrasound of the lower limbs' veins seven days after surgery to diagnose DVT. The outcomes of the two groups were then compared. A total of 100 patients participated in the clinical trial and were equally assigned to the aspirin and enoxaparin groups. Both groups were homogeneous regarding the basic and clinical characteristics. The incidence of postoperative DVT was 4.0% in the aspirin group and 10.0% in the enoxaparin group (p=0.092). The incidence of hemorrhage was 2.0% in the aspirin group and 4.0% in the enoxaparin group (p=0.610). These findings indicate that aspirin may be a promising alternative to enoxaparin for DVT prevention after surgery, but additional research is essential to validate these results and further assess the benefits and risks associated with aspirin usage in this context. Level of evidence: II

The combination of aspirin (ASP) and clopidogrel (CLD) has demonstrated efficacy in managing coronary syndromes, including unstable angina and myocardial infarction. This regimen prevents clotting and effectively reduces the risk of vascular events by inhibiting both adenosine diphosphate and the cyclooxygenase pathway. Furthermore, cholesterol-lowering agents such as statins are also employed as a preventive measure for patients with acute coronary syndromes (ACS). This article reviews the current analytical methods for the quantitative determination of aspirin in combination with clopidogrel, or the combination of the two drugs with one of the statins, in various marketed formulations in the period of 2005 -2024. The most commonly used methods for determining these combinations include chromatographic techniques such as high-pressure liquid chromatography (HPLC) and thin-layer chromatography (TLC), as well as spectrophotometric methods. Recent trends in the analysis of these combination samples show a preference for HPLC (60%), thin-layer chromatography (TLC) (22.5%) and spectrophotometric methods (17.5%) reflecting a general shift towards more sensitive methods with higher resolution capabilities. These methods also offer the advantages of requiring smaller quantities of samples and reagents and shorter analysis times.

Pre-eclampsia (PE) is a multiorgan disorder that affects 2-5% of all pregnant women. Present recommendations for when to start aspirin in high-risk women are after 11 wk of gestation.

We present a protocol to investigate the effectiveness of aspirin use from early pregnancy, which is a randomized controlled trial to assess whether prescribed low-dose aspirin from early pregnancy reduces the prevalence of early and late-onset PE. Additionally, to compare the effectiveness of aspirin administration before and after 11 wk in reducing the occurrence of PE?

All pregnancies at risk of PE, according to demographic and midwifery history, who are referred to the Maternal-Fetal Clinic of Tehran University hospital, Tehran, Iran were invited to take part in the trial. The outcomes of pregnancy and newborns will be gathered and analyzed. The first registration for the pilot study was in January 2023, and the participants were recognized as high-risk for PE. In addition, enrollment in the main study will begin as of October 2023.

To explore the safety and efficacy of bipolar plasma-kinetic transurethral resection of the prostate in patients taking low-dose aspirin.

Benign prostatic hyperplasia (BPH) patients who underwent surgical treatment from November 2018 to May 2020 were retrospectively analyzed, and divided into two groups according to whether taking 100mg aspirin daily aspirin or not. The perioperative indexes, complications and sequelae also were used to evaluate safety. The efficacy was evaluated by the functional outcomes in 3,6,12 months.

There were no statistical differences in the baseline characteristics or perioperative indicators and complications and sequelae, except for a longer operative time(90.49 ± 14.34 vs 84.95 ± 15.49; 95%CI: 0.26-10.83; P = .040) and a shorter hospital stay time(HST) (8.52 ± 1.55 vs 9.09 ± 1 .50; 95% CI: 0.21-1.11; P = .042) in the non-aspirin group. During the 12-months follow-up period, the functional outcomes of the two groups were significantly improved except International Index of Erectile Function (IIEF-5).

Based on our research results, PKRP a safe and effective method for patients with BPH who taking 100mg aspirin daily.

A gastric ulcer is a mucosal lesion of the stomach that may occur after taking nonsteroidal anti-inflammatory drugs such as aspirin, especially in cardiovascular diseases. The aim of this study was to evaluate the cytoprotective effects of the aqueous extract of oak (Jaft) against the mucosal damage effects of aspirin.

Seventy-two female Wistar rats weighing 200‒240 g were prepared and divided into 6 groups. Groups I, II, and III received the Jaft extract at doses of 250 mg/kg/d, 500 mg/kg/d, and 750 mg/kg/d, respectively, and Group IV received omeprazole at a dose of 200 mg/kg/d. Groups V (patient’s control) and VI (healthy control) both received saline (0.9%) at 1 mL/kg/d . Mice were given aspirin (200 mg/kg/d) for inducing the gastric ulcer. After 14 days, they were anesthetized with ether, their stomachs were removed, and the blocks of tissue were prepared. The tissues were stained using the hematoxylin-eosin (H&E) dye and analyzed by the Olympus light microscope and OLYSIA software. Finally, IBM SPSS 26.0 software was used for statistical analysis of the data.

The means ± standard deviation (SD) of the mucosal thickness in groups taking the Jaft extracts (250, 500, and 700 mg) decreased compared to the aspirin group (P < 0.05). In addition, the mean ± SD of the mucosal gland thickness and mucosal folds in group V (with aspirin) decreased compared to the 250, 500, and 700 extract groups (P > 0.05). The epithelial cell destruction, edema, venous congestion, and destruction of the capillaries of the mucosal and sub-mucosal areas in the extract groups decreased compared to the V group. Likewise, the number of mucosal cells in the gastric gland and the size of gastric parietal cells in the extract groups decreased compared to the V group.

This study generally elucidated the cytoprotective effect of the Jaft extract in the mouse model of gastric ulcer.

Our purpose was to investigate the association between Mammographic breast density (MBD), a known strong marker for breast cancer and metformin and aspirin use and duration of use alone or simultaneously, in a sample of Iranian women considering other confounding factors.

In a cross-sectional study, 712 individuals were selected out of women referred to two university hospitals for screening mammography. Participants’ information was collected with a questionnaire. Four-category density scale (a = almost entirely fatty, b = scattered fibroglandular densities, c= heterogeneously dense, and d = extremely dense) was categorized as low (a&b) and high (c&d) density.

The mean age of the participants was 49.80 ± 7.26 years. Sixty-five percent of women belonged to the high and 35% to the low MBD category. Both aspirin and metformin had a significantly negative association with MBD, however, when confounding factors were entered into the models, only aspirin after adjustment for age and BMI had an inverse association with MBD (OR = 0.53, 95% CI: 0.35-0.94). Simultaneous use of metformin and aspirin (OR = 0.44, 95 %CI: 0.17-1.12) was associated with lower MBD. Furthermore, in women who used metformin (OR = 0.23, 95% CI: 0.09-0.62) and aspirin (O R= 0.35, 95% CI: 0.17-0.72) for 2 to 5 years, MBD was significantly lower. However, after the adjustment of confounding factors, these associations were not statistically significant.

It seems metformin and aspirin intakes are associated with MBD. However, further studies with more sample size are needed.

 Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest cancers, with a five-year survival rate of approximately 5%. The incidence and mortality rates of PDAC are increasing, and the results of medical treatments remain unsatisfactory. Some conflicting evidence suggests that aspirin intake may reduce the risk of PDAC. This study aimed to evaluate the association between regular low-dose aspirin use (80-mg aspirin tablets, 5-7 tablets/week) and the risk of PDAC.

 This prospective, hospital-based, case-control study was performed on 470 PDAC patients (case group) and 526 sex and age-matched controls, in Tehran, Iran from 2011 to 2018. The participants were interviewed regarding the patterns of aspirin use. Data are expressed as mean±SD or frequency and percentage as appropriate. Differences in frequency between the case and control groups were evaluated based on the analysis of the contingency table (χ2 test and Fisher’s exact test). Propensity score models were designed to calculate odds ratios (OR) and 95% confidence intervals (95% CIs) for PDAC with respect to aspirin use, adjusted for age, sex, smoking status, opium use, diabetes mellitus, place of residence, and family history of cancer in first-degree relatives.

 About 60% of PDAC patients were male in this study. Also, 25.2% of PDAC patients had a family history of cancer in one of their first-degree relatives, 21.99% were smokers, 13.9% were opium users, and 11.7% had a history of diabetes. Aspirin was used by 22.77% of PDAC patients and 18.25% of the controls. Ever aspirin use (OR: 1.01, 95% CI: 0.89 – 1.14) was not associated with PDAC.

 Overall, aspirin use was not associated with a reduced risk of PDAC.

 According to the poison center data for most countries, more than thousands of people’s exposure to aspirin or salicylate-containing products. So, this work aimed was to offer a rapid colorimetric method for monitoring aspirin concentration in exhaled breath condensate (EBC).

 A method based on a redox reaction catalyzed by nanoparticles was validated for the analysis of aspirin. 3,3 ,5,5 –Tetramethyl benzidine /H2 O2 and sodium dodecyl sulfate modified silver nanoparticles were used as the redox reagents and catalyst, respectively.

 Detection mechanism of aspirin using this system is based on the inhibitory effect of aspirin on the signal intensity of the colorimetric systems. Since the decrement in signal intensity was proportional to aspirin level, a colorimetric method was proposed for its quantification in EBC samples. This method shows a linear relationship with aspirin concentration in the range of 10‒250 mg.L−1 with a relative standard deviation of < 3.5%.

 This method has great potential for aspirin determination due to some features such as high reliability, and fast response time.

 A hemocompatible substrate can offer a wonderful facility for nitric oxide (NO) production by vascular endothelial cells in reaction to the inflammation following injuries. NO inhibits platelet aggregation this is especially critical in small-diameter vessels.

 The substrate films were made of polyurethane (PU) in a casting process and after plasma treatments, their surface was chemically decorated with polyethylene glycol (PEG) 2000, gelatin, gelatin-aspirin, gelatin-heparin and gelatin-aspirin-heparin. The concentrations of these ingredients were optimized in order to achieve the biocompatible values and the resulting modifications were characterized by water contact angle and Fourier transform infra-red (FTIR) assays. The values of NO production and platelet adhesion were then examined.

 The water contact angle of the modified surface was reduced to 26±4⸰ and the newly developed hydrophilic chemical groups were confirmed by FTIR. The respective concentrations of 0.05 mg/ml and 100 mg/mL were found to be the IC50 values for aspirin and heparin. However, after the surface modification with aspirin, the bioactivity of the substrate increased in compared to the other experimental groups. In addition, there was a synergistic effect between these reagents for NO synthesis. While, heparin inhibited platelet adhesion more than aspirin.

 Because of the highly hydrophilic nature of heparin, this reagent was hydrolyzed faster than aspirin and therefore its influence on platelet aggregation and cell growth was greater. Taken together, the results give the biocompatible concentrations of both biomolecules that are required for endothelial cell proliferation, NO synthesis and platelet adhesion.

Aspirin (ASA) is often stopped prior to percutaneous nephrolithotomy (PCNL) due to the surgical bleeding risk. However, this practice is based on expert opinion only, and mounting evidence suggests holding aspirin perioperatively can be more harmful than once thought. In our review we aimed to discuss the safety of low dose aspirin continued or discontinued in the whole perioperative period of PCNL.

We performed a computerized PubMed, EMBASE and Cochrane Library search of relevant studies. Study identification satisfied the PRISMA guidelines. Newcastle-Ottawa scale (NOS) was used to evaluate the quality of including studies. Favored outcomes such as operative time, complications and change in hemoglobin were extracted. Statistical analysis was performed with Rev-Man software 5.3 and forest plots were used to illustrate our findings.

After screening, four studies were included in the present systematic review. There was no difference in the number of total complications (OR:1.25; 95 % CI 0.82-1.90; p=0.30), major complications (OR: 1.24; 95 % CI 0.53-2.93; p=0.62) and blood transfusion rate (OR:0.99; 95 % CI 0.46-2.12; p=0.98) between the continuing low dose aspirin group and discontinuing group. Moreover, the overall stone-free rate was also not statistically significant (OR:3.17; 95 % CI 0.89-11.25; p=0.07). It was similar about the change in hemoglobin, hematocrit and creatinine levels between two groups.

Based on our findings, transient cessation of aspirin perioperatively seems not to be necessary for patients who need PCNL complicated with the necessity of aspirin therapy. However, further well-designed prospective studies with large sample size are needed to confirm and validate our findings.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a family of drugs that are among the most commonly prescribed drugs worldwide. Due to the ease of access and widespread use of these drugs, many cases of intentional and accidental poisoning of these compounds have been reported.The aim of this study was to determine the prevalence of the clinical signs of drug toxicity with aspirin and NSAIDs in patients referred to Razi Hospital in Ahwaz. In this study, patients suffering from aspirin and NSAIDs poisoning referred to Razi Hospital during 2013-2015 were included in the study. Information reviewed from their stored records includes clinical presentation, demographic information, reference data, and treatment options. In this study, 79.5% were female respondents and 20.5% were male, and Faye and Kramer coefficients confirmed the existence of a strongly separate relationship between the gender variable and the first clinical signs of poisoning. The results showed that Diclofenac with 27% had the highest toxicity and nausea was the most common symptom in all drug toxicity with aspirin and NSAIDs. Nausea is a common symptom of poisoning with these drugs. There was a significant relationship between laboratory changes with the type of drug and the need for ICU admission, and this relationship was not strong due to the index values. According to the results, most of the patients were aged between 14-24 years old. Nausea was the most common symptom in all drug toxicity with aspirin and NSAIDs.

As a severe mental health condition, schizophrenia presents a chronic and complex clinical manifestation and neuropathology. A large body of literature exists on the pharmacological treatment of schizophrenia. However, evidence on some dimensions of such interventions (e.g., eligible candidates, potential predicting factors of the therapeutic outcomes, safe implementation of these interventions, etc.) are notably scarce. Studies revealed superior influences of adjunct statin therapy over placebo among patients with schizophrenia. The study aimed to investigate the effects of aspirin and simvastatin as adjunctive therapy, compared to placebo on positive and negative symptoms and general psychopathology of patients with schizophrenia.

This is a double-blind, randomized clinical trial. The sample size was estimated to be 15 individuals for each one of the three research groups (n=45). The Positive And Negative Syndrome Scale (PANSS) and the Hamilton Rating Scale For Depression (HAM-D) were employed to collect the study data in the present study. The study patients were recruited from patients admitted to the psychiatric wards of Razi Hospital were identified. The study subjects were randomly divided into two test groups and one control group. All groups were initially treated with risperidone 4 mg daily for 3 weeks. Then, group A received aspirin (325 mg twice daily), whereas group B was prescribed 40 mg/d of simvastatin. However, the control group received a placebo. Psychiatric symptoms were recorded according to the PANSS at the beginning of the study and then at weeks 4 and 8. The results were analyzed using inferential statistics (repeated-measures analysis of covariance) and descriptive statistics in SPSS software v. 20.

Of 45 patients, 35(77.78%) were men (Mean±SD age: 45.8±10.5 years), and 10(22.23%) were women (Mean±SD age: 42.3±7.8 years). The mean scores of the positive symptoms of PANSS significantly decreased in the groups treated with aspirin and simvastatin (P=0.006 and P=0.005, respectively). However, no such difference was seen in the controls (P=0.447). Furthermore, the mean scores of the negative symptoms of PANSS significantly decreased in the intervention groups (P<0.001); in addition, no significant differences were seen in the controls after the end of the research program (P=0.18). In addition, the mean scores of the general symptoms of PANSS significantly decreased in the aspirin and simvastatin groups (P<0.001). There was an increase in the same value in the controls, but the increase was not significant (P=0.31). Finally, while the total mean scores of the PANSS increased in the control group (P=0.25), the corresponding scores significantly decreased in the test groups receiving aspirin and simvastatin (P<0.001).

The present study results indicate that either aspirin or simvastatin can reduce the symptoms of schizophrenia, including general psychopathology, negative symptoms, and positive symptoms in the explored patients. Also, the effectiveness of both drugs was similar, and no significant difference was detected between these medications in reducing the symptoms mentioned above.