Antioxidant treatments for schizophrenia

Magalhães, Pedro V. S.; Andreazza, Ana Cristina; Berk, Michael; Kapczinski, Flávio; Dean, Olivia

doi:10.1002/14651858.cd008919

Cited by 6 publications

(7 citation statements)

References 33 publications

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“…12 Regarding the use of antioxidants as adjunctive therapy for schizophrenia, a Cochrane review showed that the results are still inconclusive, partially owing to the short follow-up periods because the median follow-up was 8 weeks. 13 α-Lipoic acid (ALA) and its reduced form, dihydrolipoic acid, are potent antioxidant 14 and anti-inflammatory molecules. 15 Several investigations of the use of ALA in the central nervous system range from neurological to psychiatric disorders.…”

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confidence: 99%

“…Therefore, antioxidant therapy may mitigate the symptoms of schizophrenia and the adverse effects of the medications commonly used to treat it 12 . Regarding the use of antioxidants as adjunctive therapy for schizophrenia, a Cochrane review showed that the results are still inconclusive, partially owing to the short follow-up periods because the median follow-up was 8 weeks 13 …”

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α-Lipoic Acid as Adjunctive Treatment for Schizophrenia

Junior

Filho²,

Frota

et al. 2023

J Clin Psychopharmacol

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Background/PurposeThere is evidence for low endogenous antioxidant levels and oxidative imbalance in patients with schizophrenia. A previous open-label study with α-lipoic acid (ALA), a potent antioxidant, improved patients' negative and cognitive symptoms and markers of lipid peroxidation. Here we report the results of a randomized double-blind, placebo-controlled study to verify the response of patients with schizophrenia to adjunctive treatment with ALA (100 mg/d) in a 4-month follow-up.MethodsWe conducted a 16-week, double-blind, placebo-controlled study of ALA at 100 mg/d dosages. We compared negative and positive symptoms, cognitive function, extrapyramidal symptoms, body mass index, and oxidative/inflammatory parameters between placebo and control groups.ResultsWe found no significant improvement in body mass index, cognition, psychopathology, antipsychotic adverse effects, or oxidative stress and inflammation in the experimental group compared with placebo. The whole group of patients improved in several measures, indicating a strong placebo effect in this population. A surprising finding was a significant decrease in red blood cells, white blood cells, and platelets in the group treated with ALA.ConclusionsThe decrease in red blood cells, white blood cells, and platelet counts requires further investigation and attention when prescribing ALA for patients with schizophrenia.

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confidence: 99%

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confidence: 99%

α-Lipoic Acid as Adjunctive Treatment for Schizophrenia

Junior

Filho²,

Frota

et al. 2023

J Clin Psychopharmacol

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“…Augmentation refers to a concomitant use of a pharmacological agent from another class of medicines to potentiate the effects of an ongoing compound. To augment antipsychotic medication in schizophrenia, various classes of drugs, including anticonvulsants and mood stabilizers (valproate, lamotrigine or lithium [Sommer et al , 2012; Leucht et al , 2015; Wang et al , 2016]), or less commonly, sex hormones, oxytocin (Heringa et al , 2015), anti-inflammatory agents (Keller et al , 2013; Nitta et al , 2013), glutamatergic drugs (Zink and Correll, 2015), acetylcholine esterase inhibitors (Santos et al , 2018), antioxidants (Magalhães et al , 2016), or sildenafil (Akhondzadeh et al , 2011) have been used, all with mixed or disappointing results.…”

Section: Augmentation Of Antipsychotics In Schizophreniamentioning

confidence: 99%

Mirtazapine in schizophrenia – an undeservedly overlooked option?

Terevnikov

Joffe

2022

International Clinical Psychopharmacology

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Mirtazapine has often been prescribed as add-on treatment for schizophrenia in patients with suboptimal response to conventional treatments. In this review, we evaluate the existing evidence for efficacy and effectiveness of add-on mirtazapine in schizophrenia and reappraise the practical and theoretical aspects of mirtazapine-antipsychotic combinations. In randomized controlled trials (RCTs), mirtazapine demonstrated favourable effects on negative and cognitive (although plausibly not depressive) symptoms, with no risk of psychotic exacerbation. Mirtazapine also may have a desirable effect on antipsychotic-induced sexual dysfunction, but seems not to alleviate extrapyramidal symptoms, at least if combined with second-generation antipsychotics. It is noteworthy that all published RCTs have been underpowered and relatively short in duration. In the only large pragmatic effectiveness study that provided analyses by add-on antidepressant, only mirtazapine was associated with both decreased rate of hospital admissions and number of in-patient days. Mirtazapine hardly affects the pharmacokinetics of antipsychotics. However, possible pharmacodynamic interactions (sedation and metabolic offence) should be borne in mind. The observed desired clinical effects of mirtazapine may be due to its specific receptor-blocking properties. Alternative theoretical explanations include its possible neuroprotective effect. Further well-designed RCTs and real-world effectiveness studies are needed to determine whether add-on mirtazapine should be recommended for difficult-to-treat schizophrenia.

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“…Schizophrenia, a serious mental illness identified by misinterpretation of reality, affecting more than 50 million people worldwide; It is a biological disorder that occurs in brain and causes deterioration in brain structure and function [16]. Oxidative stress causes damage to brain and its gray matter, causing difficulties in people's daily functioning [16]. While oxidative stress increases in patients with acute schizophrenia, antioxidant activity decreases [17].…”

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confidence: 99%

Therapeutic effects of transcranial direct current stimulation on ketamine-induced schizophrenia-like behaviors and oxidative stress

Akçay¹

2023

Med-Science

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Schizophrenia is a serious neuropsychiatric disorder that affects 1% of the world's population. It plays an important role in psychiatric symptoms, including major depression and schizophrenia. However, it is also known that one of the main reasons underlying the pathogenesis of schizophrenia is oxidative stress. Transcranial direct current stimulation (tDCS) has recently been a promising method for modifying neuronal membrane stimulation, cognition, and behavioral function. Our aim in this study is to explore the effects of 0.5 mA anodal tDCS stimulation on schizophrenia-like behaviors and oxidative stress in a ketamine-induced schizophrenia model. 30 male Balb/C mice were divided into 3 groups as control, schizophrenia, and schizophrenia+tDCS. The schizophrenia model was created by administering 25mg/kg/day ketamine for 7 days. tDCS treatment was performed by giving 0.5 mA anodal tDCS stimulation for 7 days. On day 14 of the experiment, SCZ-like behaviors were assessed using a novel object recognition test (NOR), open field test (OF), and tail suspension test (TST), and also oxidative stress in hippocampus and prefrontal tissues was estimated. Results showed that locomotor activity, depressive and anxiety-like behaviors of the schizophrenia group increased significantly compared to the control group and decreased after tDCS stimulation (p<0.05). In addition, it was investigated that tDCS stimulation also significantly increased learning that decreased after schizophrenia (p<0.05). All together, it was observed that the total antioxidant capacity of the schizophrenia group decreased while the total oxidant capacity of the schizophrenia group rose in the prefrontal cortex and hippocampus tissues compared to the control group (p<0.05). Otherwise, 0.5 mA anodal tDCS stimulation increased the total antioxidant capacity of the schizophrenia+tDCS group compared to the schizophrenia group, while it decreased total oxidant capacity (p<0.05). Based on our results displayed that 0.5 mA anodal tDCS stimulation for 30 minutes for 7 days reduced schizophrenia-like behaviors and oxidative stress by modulation of N-methyl-D-aspartic acid (NMDA) receptors in the glutamatergic pathway in a ketamine-induced, NMDA antagonist, schizophrenia model.

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Antioxidant treatments for schizophrenia

Cited by 6 publications

References 33 publications

α-Lipoic Acid as Adjunctive Treatment for Schizophrenia

α-Lipoic Acid as Adjunctive Treatment for Schizophrenia

Mirtazapine in schizophrenia – an undeservedly overlooked option?

Therapeutic effects of transcranial direct current stimulation on ketamine-induced schizophrenia-like behaviors and oxidative stress

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