Inflammation in patients with schizophrenia: the therapeutic benefits of risperidone plus add-on dextromethorphan.

Abstract

UNLABELLED:

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.

• Authors: 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
• Journal: Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology (J Neuroimmune Pharmacol) Vol. 7 Issue 3 Pg. 656-64 (Sep 2012) ISSN: 1557-1904 [Electronic] United States
• PMID: 22730040 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Inflammation Mediators
• Dextromethorphan
• Risperidone

Topics

• Adult
• Dextromethorphan (administration & dosage)
• Double-Blind Method
• Drug Therapy, Combination
• Female
• Humans
• Inflammation (blood, drug therapy)
• Inflammation Mediators (blood)
• Male
• Middle Aged
• Risperidone (administration & dosage)
• Schizophrenia (blood, drug therapy, pathology)
• Treatment Outcome
• Young Adult