Improvement of Sustained Attention and Visual and Movement Skills, but Not Clinical Symptoms, After Dehydroepiandrosterone Augmentation in Schizophrenia

Abstract

This short-term study does not support DHEA's value as an effective adjunct in the treatment of symptoms, side effects, and quality-of-life impairment in schizophrenia, while suggesting that DHEA improves sustained attention and visual and movement skills. A long-term, large-scale study with a broader dose range is warranted to further investigate DHEA's role in the management of schizophrenia.

Sex hormones and oxytocin augmentation strategies in schizophrenia: A quantitative review

“…Twenty-four randomized controlled trials were retrieved that met our inclusion criteria, investigating the efficacy of hormonal augmentation on total, positive, and negative symptoms in a total of 1149 patients (Kulkarni et al, 2001(Kulkarni et al, , 2008(Kulkarni et al, , 2010(Kulkarni et al, , 2011(Kulkarni et al, , 2014Akhondzadeh et al, 2003;Louzã et al, 2004;Nachshoni et al, 2005;Ritsner et al, 2006aRitsner et al, , 2006bRitsner et al, , 2014Strous et al, 2007;Ko et al, 2008;Marx et al, 2009Marx et al, , 2014Feifel et al, 2010;Ritsner, 2010;Pedersen et al, 2011;Usall et al, 2011;Ghafari et al, 2013;Lee et al, 2013;Modabbernia et al, 2013;Cacciotti-Saija et al, 2014;Gibson et al, 2014;Kianimehr et al, 2014) (Table 1). Multiple dosages reported within a single study are represented separately.…”

“…Of the 24 included studies, 2 studies (Ritsner et al, 2006b;Feifel et al, 2010) had a crossover design, although in both articles the authors note that carryover effects were found to be nonsignificant. In all studies, included patients were treated with a stable dose of antipsychotic medication before the study started, which did not change during the augmentation period.…”

“…Four studies (Nachshoni et al, 2005;Strous et al, 2007;Ritsner et al, 2010Ritsner et al, , 2006b) could be included on DHEA augmentation, including a total of 160 male and female patients (Table 1). We found no significant difference between DHEA and placebo for total symptoms (Hedges' g = 0.04, p = 0.765; Fig.…”

“…Twelve studies examined cognitive function in at least one domain as an outcome measure (Ritsner et al, 2006bStrous et al, 2007;Pedersen et al, 2011;Feifel et al, 2012;Cacciotti-Saija et al, 2014;Gibson et al, 2014;Huerta-Ramos et al, 2014;Kreinin et al, 2014;Kulkarni et al, 2014;Marx et al, 2014Marx et al, , 2009 (Table 2). In all instances, effects of hormonal augmentation on cognitive functioning were studied alongside effects on positive and negative symptomatology as described in the papers discussed above, but in three papers Fig.…”

“…Significant improvements relative to placebo were found in executive functioning after pregnenolone , in visual attention after DHEA and pregnenolone , and in processing speed after pregnenolone . Five studies examined visuospatial, constructional, and movement skills; significant effects were found only for DHEA (Ritsner et al, 2006a(Ritsner et al, , 2006b. One study examined verbal fluency and found a significant effect of raloxifene on phonemic fluency (Huerta-Ramos et al, 2014).…”