ANTI-INFLAMMATORY AGENTS FOR
SCHIZOPHRENIA
Norbert Müller, Michael Riedel, M.
Ackenheil, Markus J. Schwarz
Psychiatric and Psychotherapeutic
Hospital, Ludwig-Maximilians-University, Nußbaumstr. 7, 80336, Müchen
Alterations of the immune system in
schizophrenia have been described over the last century. Several lines of
evidence suggest that an inflammatory process in the central nervous system
(CNS) may play a role in schizophrenia. Although there is a controverse
discussion of the role of immunological findings in schizophrenia and more
insight into the pathological process is needed, we performed a systematic
clinical trial of anti-inflammatory treatment in schizophrenia using the
selective cycloxgenase-2 inhibitor celecoxib in order to evaluate the
therapeutic effects. This study was performed as a single-center
double-blind, placebo-controlled randomized, add-on, parallel-group evaluation
of risperidone and celecoxib versus risperidone and placebo. Fifty
schizophrenic patients were included in the study, of whom 25 received 2-6 mg
risperidone/day and placebo, and 25 risperidone and 400 mg/day celecoxib for 5
weeks after wash-out. Both groups of schizophrenic patients showed
significant improvement on the overall positive- and negative syndrome scale
(PANSS), and on all subscales, during the five week treatment with
risperidone. However, the celecoxib add-on therapy group had significantly
more decrease in the PANSS total score over weeks 2-4 (ANCOVA). The
results show that additional treatment with celecoxib has significant positive
effects on the schizophrenic total psychopathology. Moreover, since
treatment with an immunomodulatory drug shows beneficial effects on the
schizophrenic symptomatology, this result represents another indication that
immune dysfunction in schizophrenia is not just an epiphenomen but related to
the pathomechanism of the disorder. In parallel immune parameters were
estimated and the immunological results will be discussed regarding an
immunological model of schizophrenia.
This work was supported by the Vada and
Theodore Stanley Foundation.