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Anti-inflammatory Agents for Patients with Schizophrenia

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Immuno-Psychiatry

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Abstract

Evidence shows that a propensity toward a pro-inflammatory status in the brain plays an important role in schizophrenia. Anti-inflammatory drugs might compensate this propensity. This study provides an update regarding the efficacy of agents with some anti-inflammatory actions for schizophrenia symptoms tested in randomized controlled trials (RCTs). For this literature update, PubMed, Embase, the National Institutes of Health website (http://www.clinicaltrials.gov), and the Cochrane Database of Systematic Reviews were systematically searched for RCTs that investigated clinical outcomes. Our search yielded 56 studies that provided information on the efficacy of the following components on symptom severity: aspirin, bexarotene, celecoxib, davunetide, dextromethorphan, estrogens, fatty acids, melatonin, minocycline, N-acetylcysteine (NAC), pioglitazone, piracetam, pregnenolone, statins, varenicline, and Withania somnifera extract. The results of aspirin [mean weighted effect size (ES): 0.30; n = 270; 95% CI (CI) 0.06–0.54], estrogens (ES: 0.78; n = 723; CI 0.36–1.19), minocycline (ES: 0.40; n = 946; CI 0.11–0.68), and NAC (ES: 1.00; n = 442; CI 0.60–1.41) were significant in meta-analysis of at least two studies. Subgroup analysis yielded larger positive effects for first-episode psychosis (FEP) or early-phase schizophrenia studies. Bexarotene, celecoxib, davunetide, dextromethorphan, fatty acids, pregnenolone, statins, and varenicline showed no significant effect. In conclusion we found that some, but not all, agents with anti-inflammatory properties showed efficacy. Effective agents were aspirin, estrogens, minocycline, and NAC. We observed greater beneficial results on symptom severity in FEP or early-phase schizophrenia.

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Authors and Affiliations

  1. Antes Center for Mental Health Care, Poortugaal, The Netherlands

    Nico J. M. van Beveren

  2. Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands

    Nico J. M. van Beveren

  3. Department of Neuroscience, Erasmus Medical Center, Rotterdam, The Netherlands

    Nico J. M. van Beveren

  4. Department of Psychiatry and Amsterdam Neuroscience, Academic Medical Center, Amsterdam, The Netherlands

    Nuray Çakici

  5. Department of Psychiatry and Biomedical Sciences of Cells and Systems, University Medical Center Groningen, Groningen, The Netherlands

    Iris E. Sommer

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  1. Nico J. M. van Beveren
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  2. Nuray Çakici
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  3. Iris E. Sommer
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Correspondence to Iris E. Sommer .

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Editors and Affiliations

  1. Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, VIC, Australia

    Michael Berk

  2. University Paris Est Créteil (UPEC), Inserm, IMRB (Translational NeuroPsychiatry lab), AP-HP, DMU IMPACT, AP-HP, Fondation FondaMental, Créteil, France

    Marion Leboyer

  3. UMC Groningen, Groningen, The Netherlands

    Iris E. Sommer

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van Beveren, N.J.M., Çakici, N., Sommer, I.E. (2021). Anti-inflammatory Agents for Patients with Schizophrenia. In: Berk, M., Leboyer, M., Sommer, I.E. (eds) Immuno-Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-71229-7_22

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