A review of anti-inflammatory agents for symptoms of schizophrenia

Keller, William R.; Kum, Lionel M; Wehring, Heidi J.; Koola, Maju Mathew; Boyer, Robert; Kelly, Deanna L.

doi:10.1177/0269881112467089

Cited by 90 publications

(69 citation statements)

References 51 publications

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“…Lastly, based on the neuroinflammatory hypothesis of schizophrenia (Kirkpatrick and Miller, 2013;Na et al, 2014) and that some patients benefit from the effects of adjunct anti-inflammatory therapies (Keller et al, 2013;Sommer et al, 2012), this could be another mechanism by which CBD may exert its antipsychotic effects. This hypothesis is supported by evidence which has shown that CBD has anti-inflammatory properties (Burstein, 2015).…”

Section: Potential Mechanisms Of Antipsychotic Effectmentioning

confidence: 99%

Does cannabidiol have a role in the treatment of schizophrenia?

Gururajan

Malone

2016

Schizophrenia Research

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Section: Potential Mechanisms Of Antipsychotic Effectmentioning

confidence: 99%

Does cannabidiol have a role in the treatment of schizophrenia?

Gururajan

Malone

2016

Schizophrenia Research

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“…The remission of psychotic symptoms in this patient has been associated with maintenance of the gluten-free diet, but it is also possible that the minocycline he was taking for acne contributed to his recovery, since this antibiotic has been associated with improvement of schizophrenia symptoms in several studies (22, 23). However, both risperidone and minocycline have since been discontinued.…”

Section: Discussionmentioning

confidence: 87%

Improvement in Psychotic Symptoms After a Gluten-Free Diet in a Boy With Complex Autoimmune Illness

Eaton¹,

Chen

Dohan

et al. 2015

AJP

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CASE PRESENTATION At age 8, “Chris,” a Caucasian boy, experienced intermittent auditory and visual hallucinations, but without bizarre behaviors or much deterioration in functioning. At age 15, he developed a depressed mood, started talking to himself, and became socially withdrawn, and his academic performance declined. He was hospitalized and diagnosed as having major depressive disorder with psychotic features. MRI and EEG showed no abnormalities. Treatment with escitalopram (10 mg/day) and aripiprazole (5 mg/day) had little effect. Several weeks after discharge, he was admitted for a second time with the same diagnosis; a third admission, again with the same diagnosis, occurred several months after that. At age 16, Chris developed visual and auditory hallucinations with homicidal ideations. He cut himself superficially following the command of voice hallucinations, and he was hospitalized again, with the diagnosis changed to schizophrenia, paranoid type. During this inpatient stay, he was treated with venlafaxine (150 mg/day) and risperidone (1.5 mg/day). During the same admission, a blood test showed the presence of antinuclear antibodies (ANAs), but the patient had no symptoms of any autoimmune disease. In the meantime, he was also receiving clindamycin/benzoyl peroxide and adapaline gels and minocycline for acne and fluticasone nasal spray and albuterol for asthma. An allergy to gluten was demonstrated by an assay (Accessa Labs) that showed only IgE antigluten antibodies. Chris’sparents reported that he developed anallergy to peanuts and soy at about the same time. Gluten was removed from his diet at the suggestion of the mother, a licensed dietitian. After the dietary change, the intensity of Chris’s auditory hallucinations declined dramatically and the violent element diminished, and he was discharged after 9 weeks. During the next 2 years, Chris remained on a gluten-free diet, which he and his family associated with the disappearance of his psychotic symptoms. Sensitivity to gluten was demonstrated by an assay (Metametrix Clinical Laboratory) of a stool sample that yielded a value of 10.6 mg/dL of IgA antigliadin antibodies, in the top quintile of the reference range. The dosage of risperidone was tapered to 0.5 mg/day, and no auditory or visual hallucinations occurred, although when the dosage was lowered to 0.25 mg/day, Chris reported feeling anxious, and the dosage was returned to 0.5 mg/day for a time. Eventually the risperidone was discontinued completely. Chris was able to return to school, where his academic performance was normal and he joined several athletic teams. At age 16, after his hospital stay, Chris lost his hearing suddenly and was fitted with a hearing aid. His ANA level was high, and the diagnosis of autoimmune inner ear disease was made. He was treated with prednisone and then methotrexate over a 2-month period. Despite his hearing loss, he has maintained a high level of functioning, including learning to read lips, and he has continued to play competitive sports. Both of Chris’s p...

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“…For example, add-on antiinflammatory agents could be used in conjunction with existing antipsychotics to target these molecules and their pathways (Keller et al, 2013). This approach is discussed in further detail in Section 4.…”

Section: Potential Confounding Effects Of Psychological Stress and Otmentioning

confidence: 99%

The Potential of Immune Biomarkers to Advance Personalized Medicine Approaches for Schizophrenia

Cox

Chan

Bahn

2015

Journal of Nervous &Amp; Mental Disease

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Molecular profiling studies have helped increase the understanding of the immune processes thought to be involved in the etiology and pathophysiology of psychiatric disorders such as schizophrenia. Current therapeutic interventions with first- and second-generation antipsychotics are suboptimal. Poor response rates and debilitating side effects often lead to poor treatment compliance. This highlights the pressing need to identify more effective treatments as well as objective biomarker based tests, which can help predict treatment response and identify diagnostic subpopulations. Such tests could enable early detection of patients who will benefit from particular therapeutic interventions. In this review, we discuss studies relating to dysfunctions of the immune system in patients with schizophrenia and the effects of antipsychotic medication on the molecular components of these systems. Immune system dysfunction may in part be related to genetic risk factors for schizophrenia, but there is substantial evidence that a wide range of environmental factors ranging from exposure to infectious agents such as influenza and Toxoplasma gondii to HPA axis dysfunction play an important role in the etiopathogenesis of schizophrenia. Ongoing research efforts, testing therapeutic efficacy of anti-inflammatory agents used as add-on medications are also discussed. From a therapeutic perspective, these represent the initial steps toward novel treatment approaches and more effective patient care in the field of mental health.

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A review of anti-inflammatory agents for symptoms of schizophrenia

Cited by 90 publications

References 51 publications

Does cannabidiol have a role in the treatment of schizophrenia?

Does cannabidiol have a role in the treatment of schizophrenia?

Improvement in Psychotic Symptoms After a Gluten-Free Diet in a Boy With Complex Autoimmune Illness

The Potential of Immune Biomarkers to Advance Personalized Medicine Approaches for Schizophrenia

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