There is preliminary evidence to suggest that use of an NSAID to augment antipsychotic drugs has a moderate beneficial effect on symptom severity for people with schizophrenia in the short term.
Immune dysfunction and inflammation have been described in patients with schizophrenia. For example, findings from our group suggested that markers for inflammation, including elevated blood levels of C reactive protein and white blood cell count are associated with negative symptoms in patients with schizophrenia. Furthermore, nuclear factor κB activation may play a pivotal role in schizophrenia through interaction with cytokines.
This meta-analysis was based on five double-blind, randomised, placebo-controlled trials with a total number of 264 patients. Four studies examined celecoxib and one used aspirin. The studies included were heterogeneous in terms of the chronicity of illness and the choice of study drugs; in addition, the study time periods were relatively short (up to three months). Despite these limitations, the analysis provided further evidence suggesting that non-steroidal anti-inflammatory drug augmentation treatment could be beneficial in reducing schizophrenia symptoms.
Celecoxib and other cyclooxygenase-2 (COX-2) inhibitors are associated with an elevated risk of cardiovascular disease, which is a serious comorbid medical condition in patients with schizophrenia. The cardioprotective nonselective COX inhibitor aspirin is arguably preferable. However, it is well established that aspirin, especially when used in a relatively high dosage, is associated with a significant risk for gastrointestinal bleeding.
Continued effort should be made to identify potential anti-inflammatory agents with a better side effect profile, and also examine the longer term effect of anti-inflammatory treatment in schizophrenia. Future studies focusing on the early stage of schizophrenia are particularly valuable because pharmacological treatment during the early phase could improve the course and overall prognosis of the disease.
by Xiaoduo Fan, Xueqin Song, Evidence Based Mental Health
Schizophrenia runs in families, but scientists have been stymied in their efforts to nail down genetic changes that could be causing the often devastating mental illness.
By zeroing in on just one pathway in the brain, scientists say they’ve found genetic variations that are shared in families, and tend to cause specific symptoms.
Though scientists have known for decades that schizophrenia is often hereditary, they haven’t been able to find one gene that causes it. Instead, they now think that it’s caused by lots of genetic variations, and that not everyone with the disease has the same ones. It’s as if people are being dealt cards from multiple decks, and the rules of the game are different for each person.
Some scientists have tried to solve this mystery by looking at all the cards in the deck, scanning the genes of large groups of people to look for clues. Others take a more tightly focused approach, picking one suit, or even one hand, to examine very closely.
Researchers at Johns Hopkins took the focused approach. They looked at genes controlling one pathway in the brain, called the neuregulin signaling pathway, and scanned those genes in 123 families with a history of schizophrenia. Some families did have many more variations in their neuregulin genes. And the people in those families who had schizophrenia were more likely to have hallucinations, one symptom of the disease.
By contrast, other families didn’t have neuregulin gene variations. And their family members with schizophrenia had different symptoms. They had more cognitive impairment, but fewer hallucinations.
by Nancy Shute, NPR
Rep. Tim Murphy (R. Pa.)
came out swinging hard Wednesday at SAMHSA,
during a House Oversight and Investigations subcommittee of the Energy and Commerce Committee. It was the third session Rep. Murphy’s subcommittee has held about mental illnesses and it was a good one.
SAMHSA has long been criticized by Dr. Fuller E. Torrey
for wasting money on “feel good” programs that are not evidence based, for not paying adequate attention to severe mental illnesses, and for funding organizations that advocate anti-psychiatry and anti-medical model views.
Chairman Murphy relied heavily on Dr. Torrey’s past and current criticisms in his opening statement. Among his – Rep. Murphy’s — specific criticisms were that SAMHSA doesn’t focus enough of its funding and programs on helping persons diagnosed with bipolar disorder, schizophrenia and other severe illnesses, as evidence by the fact that it has only one psychiatrist on its staff and his expertise is substance abuse, not mental illness. SAMHSA was created to be the federal government’s main mental health agency.
How can the government’s number one mental health agency only have one psychiatrist on its staff of 574 employees? Murphy asked.
by Pete Earley
A new study of first-episode psychosis has found that the longer patients are untreated following an initial episode, the longer it takes them to respond to treatment once it begins.
A team of researchers from the University of Cantabria in Spain followed 153 patients who underwent treatment following a first psychotic break (“Delayed psychosis treatment harms chance of success,” a research summary from News.Medical.net, April 29; not yet available online). Patients who achieved remission within a year of starting treatment had an average duration of untreated psychosis of 8.8 months.
Patients who did not experience remission within a year were, on average, psychotic for 15.6 months before treatment began.
The researchers found that three factors predicted remission:
1. Duration of the untreated psychosis;
2. Severity of negative symptoms;
3. No education beyond primary school.
“Early intervention clinical programs should aim to reduce the length of DUP [duration of untreated psychosis] in order to provide a better outcome for patients,” according to author Benedicto Crespo-Facorro. The authors also identified the lack of effective medications for negative symptoms as “a major unmet need in schizophrenia treatment.”
by Treatment Advocacy Center
Hospitalization for infection during childhood is associated with an increased risk of developing schizophrenia in adolescence and young adulthood, new research shows.
….”These are serious infections requiring hospitalization, so it is only the more severe cases of infections that are implicated here, and the fact that we found raised risk if the father had a history of being hospitalized for infection indicates that there may be some familial susceptibility to infection and subsequent schizophrenia risk,” Nielsen said.
….Several studies have reported links between maternal infections during pregnancy and the child’s risk for schizophrenia.
by Fran Lowry, Medscape