Pyridoxine and Schizophrenia

Bucci, L

doi:10.1192/bjp.122.2.240

Cited by 9 publications

(4 citation statements)

References 1 publication

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“…Since 1973, several clinical studies have been conducted to evaluate the efficacy of vitamin B 6 treatment for schizophrenia; however, results have been inconclusive . Previous studies used pyridoxine or pyridoxal as the vitamin B 6 therapeutic, and used dosages much lower than ours.…”

Section: Discussionmentioning

confidence: 87%

Pyridoxamine: A novel treatment for schizophrenia with enhanced carbonyl stress

Itokawa

Miyashita

Arai

et al. 2017

Psychiatry Clin Neurosci

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Aim: The aim of this clinical trial was to obtain proof of concept for high-dose pyridoxamine as a novel treatment for schizophrenia with enhanced carbonyl stress. Methods:Ten Japanese schizophrenia patients with high plasma pentosidine, which is a representative biomarker of enhanced carbonyl stress, were recruited in a 24-week, open trial in which high-dose pyridoxamine (ranging from 1200 to 2400 mg/day) was administered using a conventional antipsychotic regimen. Main outcomes were the total change in Positive and Negative Syndrome Scale score and the Brief Psychiatric Rating Scale score from baseline to end of treatment at week 24 (or at withdrawal).Results: Decreased plasma pentosidine levels were observed in eight patients. Two patients showed marked improvement in their psychological symptoms. A patient who harbors a frameshift mutation in the Glyoxalase 1 gene also showed considerable reduction in psychosis accompanied with a moderate decrease in plasma pentosidine levels. A reduction of greater than 20% in the assessment scale of drug-induced Parkinsonism occurred in four patients. Although there was no severe suicide-related ideation or behavior, Wernicke's encephalopathy-like adverse drug reactions occurred in two patients and were completely suppressed by thiamine supplementation. Conclusion:High-dose pyridoxamine add-on treatment was, in part, effective for a subpopulation of schizophrenia patients with enhanced carbonyl stress. Further randomized, placebo-controlled trials with careful monitoring will be required to validate the efficacy of high-dose pyridoxamine for these patients.

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Section: Discussionmentioning

confidence: 87%

Pyridoxamine: A novel treatment for schizophrenia with enhanced carbonyl stress

Itokawa

Miyashita

Arai

et al. 2017

Psychiatry Clin Neurosci

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“…Katsuta and colleagues 13 showed in a longitudinal study that decreased serum pyridoxal levels in patients with acute schizophrenia were normalized according to the clinical course, and the patients with decreased serum pyridoxal levels during the clinical course showed less improvement in symptoms. Furthermore, several previous studies reported the therapeutic effect of pyridoxine (1 of the 3 forms of vitamin B6) in patients with schizophrenia, [25][26][27][28][29][30] although other studies, including a meta-analysis of randomized controlled trials of vitamin B6 alone, 31 have not provided evidence of the benefits of pyridoxine in people with this disorder. 32,33 These results suggest that pyridoxine may be effective for a particular subpopulation of patients with schizophrenia, but not for general schizophrenia populations.…”

Section: Discussionmentioning

confidence: 99%

Decreased serum pyridoxal levels in schizophrenia: meta-analysis and Mendelian randomization analysis

Tomioka

Numata

Kinoshita

et al. 2018

jpn

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“…So far, a number of clinical reports, including 4 randomized placebo-controlled studies, have tested the efficacy of vitamin B6 supplementation for schizophrenia, but the results are inconsistent. [17][18][19][20][21][22][23][24] A possible reason for the conflicting results could be that in these studies, no account was taken of the vitamin B6 levels in subjects. We believe that vitamin B6 supplementation may be most effective in schizophrenic patients with lower B6 levels associated with enhanced carbonyl stress.…”

Section: Discussionmentioning

confidence: 99%

Clinical Features of Schizophrenia With Enhanced Carbonyl Stress

Miyashita¹,

Arai

Kobori

et al. 2013

Schizophrenia Bulletin

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Accumulating evidence suggests that advanced glycation end products, generated as a consequence of facilitated carbonyl stress, are implicated in the development of a variety of diseases. These diseases include neurodegenerative illnesses, such as Alzheimer disease. Pyridoxamine is one of the 3 forms of vitamin B6, and it acts by combating carbonyl stress and inhibiting the formation of AGEs. Depletion of pyridoxamine due to enhanced carbonyl stress eventually leads to a decrease in the other forms of vitamin B6, namely pyridoxal and pyridoxine. We previously reported that higher levels of plasma pentosidine, a well-known biomarker for advanced glycation end products, and decreased serum pyridoxal levels were found in a subpopulation of schizophrenic patients. However, there is as yet no clinical characterization of this subset of schizophrenia. In this study, we found that these patients shared many clinical features with treatment-resistant schizophrenia. These include a higher proportion of inpatients, low educational status, longer durations of hospitalization, and higher doses of antipsychotic medication, compared with patients without carbonyl stress. Interestingly, psychopathological symptoms showed a tendency towards negative association with serum vitamin B6 levels. Our results support the idea that treatment regimes reducing carbonyl stress, such as supplementation of pyridoxamine, could provide novel therapeutic benefits for this subgroup of patients.

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Pyridoxine and Schizophrenia

Cited by 9 publications

References 1 publication

Pyridoxamine: A novel treatment for schizophrenia with enhanced carbonyl stress

Pyridoxamine: A novel treatment for schizophrenia with enhanced carbonyl stress

Decreased serum pyridoxal levels in schizophrenia: meta-analysis and Mendelian randomization analysis

Clinical Features of Schizophrenia With Enhanced Carbonyl Stress

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