Emerging research suggests that some anti-inflammatory medicines can improve the efficacy of existing schizophrenia treatments.
A group of researchers at the University of Utrecht in the Netherlands discovered anti-inflammatory medicines such as aspirin, estrogen, and fluimucil can help improve schizophrenia symptoms.
This work was presented at the European College of Neuropsychopharmacology (ECNP) conference in Berlin.
Although physicians have believed that helping the immune system may aid the treatment of schizophrenia, until now there has been no conclusive evidence that this would be effective.
In the study, researchers carried out a comprehensive meta-analysis of all robust studies on the effects of adding anti-inflammatories to antipsychotic medication.
This has allowed them to conclude that anti-inflammatory medicines, such as aspirin, can add to the effective treatment of schizophrenia.
Experts have known that the immune system is linked to certain psychiatric disorders, such as schizophrenia and bipolar disorder. Schizophrenia in particular is linked to the HLA gene system, which is found on chromosome six in humans. The HLA system controls many of the characteristics of the immune system.
According to lead researcher Iris Sommer, Ph.D., of the Utrecht Psychiatry Department, “The picture on anti-inflammatory agents in schizophrenia has been mixed, but this analysis pulls together the data from 26 double-blind randomized controlled trials, and provides significant evidence that some (but not all) anti-inflammatory agents can improve symptoms of patients with schizophrenia.
“In particular, aspirin, estrogens in women and the common antioxidant N-acetylcysteine (fluimicil) show promising results. Other anti-inflammatory agents, including celecoxib, minocycline, davunetide, and fatty acids showed no significant effect.”
Although schizophrenia affects around 24 million people worldwide, treatment of the condition has remained consistent over the past 50 years.
Current pharmacological therapy for schizophrenia consists of correcting the regulation of dopamine.
This strategy has been shown to help symptoms such as hallucinations and delusions, but has been unable to help many other symptoms such as decreased energy, lack of motivation, and poor concentration.
In addition, around 20 to 30 percent of all patients don’t respond to antipsychotic treatment.
Researchers and other experts believe co-treatment with anti-inflammatory agents holds the possibility of improving patient’s response to treatment.
“The study makes us realize that we need to be selective about which anti-inflammatory we use,” Somner said. “Now that we know that some effects are replicated, we need to refine our methods to see if we can turn it into a real treatment.
“We have just started a multicenter trial using simvastatine to reduce inflammation in the brain of patients with schizophrenia. Studies like these will provide the proof-of-concept for targeting the immune system in schizophrenia.”
An expert associated with the ECNP, psychiatrist Dr. Celso Arango of the Hospital General Universitario Gregorio Marañón in Madrid, said, “Inflammation and oxidative stress seem to be important factors in different mental disorders.
“Patients with different mental conditions, including schizophrenia, have been shown to have reduced antioxidants in the brain as well as excess inflammatory markers.”
Arango said animal models and clinical trials have shown that antioxidants and anti-inflammatory drugs could not only reduce symptoms associated with the disorders but also prevent the appearance of neurobiological abnormalities and transition to psychosis, if given early enough during brain development.
“This work is a step towards the possibility of better treatment, but we need more research in this area, especially with younger subjects where we might expect more brain plasticity,” he said.