α-Lipoic Acid as Adjunctive Treatment for Schizophrenia

Abstract

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.

Schizophrenia Synaptic Pathology and Antipsychotic Treatment in the Framework of Oxidative and Mitochondrial Dysfunction: Translational Highlights for the Clinics and Treatment

“…In contrast, another RCT in patients with schizophrenia under supplementation with ALA found no significant improvement in body mass index, cognition, psychopathology, adverse effects of antipsychotics or oxidative stress, and inflammation in the experimental group compared to placebo. Significant decreases in red blood cells, white blood cells, and platelets were found in the entire ALA-treated group [ 129 ]. It has been reported that antipsychotic drugs can reduce inflammatory and oxidative effects by acting on the dopaminergic system [ 45 , 130 , 131 ].…”

Alpha Lipoic Acid for Schizophrenia

“…1 Treatment with alpha lipoic acid (ALA), a dihydrolipoic acid with antioxidant, antiinflammatory, and neuroprotective properties, may restore oxidative stress-induced brain damage. [2][3][4][5] To test this hypothesis, De Lima et al 2 conducted a 16-week, double-blind, placebo-controlled trial of ALA among individuals with schizophrenia who were also taking antipsychotics. However, their study showed that ALA did not have any effects on the psychopathology of individuals with schizophrenia.…”

“…However, their study showed that ALA did not have any effects on the psychopathology of individuals with schizophrenia. 2 As stated by the authors, because the number of participants included in the trial was small (n = 35), the results may be prone to type II error (ie, insufficient statistical power). By combining the results of multiple studies, a meta-analysis may be able to overcome the limitations of individual studies and increase statistical power.…”

“…6 To date, 4 double-blind, randomized, placebo-controlled trials of ALA for individuals with schizophrenia have been published (Supplemental Table S1, http:// links.lww.com/JCP/A853). [2][3][4][5] To assess the efficacy and acceptability of ALA in the treatment of schizophrenia, we conducted a systematic review and meta-analysis of these studies.…”

“…lww.com/JCP/A853). [2][3][4][5] The study characteristics are presented in Supplemental Table S1, http://links.lww.com/JCP/A853, and the risk of bias is shown in Figure S2. The mean age of the participants was 35.52 years, and 36.41% of them were men.…”