Inflammation in patients with schizophrenia: the therapeutic benefits of risperidone plus add-on dextromethorphan
Shiou-Lan Chen, Sheng-Yu Lee, Yun-Hsuan Chang, Shih-Heng Chen, Chun-Hsieh Chu, Nian-Sheng Tzeng, I-Hui Lee, Po-See Chen, Tzung Lieh Yeh, San-Yuan Huang, Yen-Kuang Yang, Ru-Band Lu, Jau-Shyong Hong, Shiou-Lan Chen, Sheng-Yu Lee, Yun-Hsuan Chang, Shih-Heng Chen, Chun-Hsieh Chu, Nian-Sheng Tzeng, I-Hui Lee, Po-See Chen, Tzung Lieh Yeh, San-Yuan Huang, Yen-Kuang Yang, Ru-Band Lu, Jau-Shyong Hong
Abstract
Increasing evidence suggests that inflammation contributes to the etiology and progression of schizophrenia. Molecules that initiate inflammation, such as virus- and toxin-induced cytokines, are implicated in neuronal degeneration and schizophrenia-like behavior. Using therapeutic agents with anti-inflammatory or neurotrophic effects may be beneficial for treating schizophrenia. One hundred healthy controls and 95 Han Chinese patients with schizophrenia were tested in this double-blind study. Their PANSS scores, plasma interleukin (IL)-1β, tumor necrosis factor-α (TNF-α) and brain-derived neurotrophic factor (BDNF) levels were measured before and after pharmacological treatment. Pretreatment, plasma levels of IL-1β and TNF-α were significantly higher in patients with schizophrenia than in controls, but plasma BDNF levels were significantly lower. Patients were treated with the atypical antipsychotic risperidone (Risp) only or with Risp+ dextromethorphan (DM). PANSS scores and plasma IL-1β levels significantly decreased, but plasma TNF-α and BDNF levels significantly increased after 11 weeks of Risp treatment. Patients in the Risp+ DM group showed a greater and earlier reduction of symptoms than did those in the Risp-only group. Moreover, Risp+ DM treatment attenuated Risp-induced plasma increases in TNF-α. Patients with schizophrenia had a high level of peripheral inflammation and a low level of peripheral BDNF. Long-term Risp treatment attenuated inflammation and potentiated the neurotrophic function but also produced a certain degree of toxicity. Risp+ DM was more beneficial and less toxic than Risp-only treatment.
Clinical trial registration: Protocol Record: HR-93-50;
Trial registration number: NCT01189006; URL: http://www.clinicaltrials.gov.
Conflict of interest statement
Conflicts of interest
None.
Figures
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(A) The plasma BDNF change percentages (%) after 11 weeks of treatment with…
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- Multicenter Study
- Randomized Controlled Trial
- Research Support, Non-U.S. Gov't
- Adult
- Dextromethorphan / administration & dosage*
- Double-Blind Method
- Drug Therapy, Combination
- Female
- Humans
- Inflammation / blood
- Inflammation / drug therapy
- Inflammation Mediators / blood*
- Male
- Middle Aged
- Risperidone / administration & dosage*
- Schizophrenia / blood*
- Schizophrenia / drug therapy*
- Schizophrenia / pathology*
- Treatment Outcome
- Young Adult
- Inflammation Mediators
- Dextromethorphan
- Risperidone
- ClinicalTrials.gov/NCT01189006
- Full Text Sources
- Medical
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Source: PubMed