Schizophrenia is among the most debilitating of all mental illnesses and affects approximately 24 million people around the world. Without effective treatment, people with schizophrenia may be unable to function independently from day to day.
Antipsychotic medications are the cornerstone of schizophrenia treatment and are usually necessary to stabilize patients before additional treatment, such as therapy and education, can be attempted. However, responses to antipsychotic medications are highly individual, and treatment often involves experimentation with different medications and dosages before patients respond well.
Schizophrenia Treatment Has Been Slow to Evolve
Between 20 percent and 30 percent of schizophrenic patients do not respond to antipsychotics, but research has been slow to identify possible alternatives or agents that could help to improve antipsychotic response rates. In addition, certain symptoms of schizophrenia, which include low energy, low motivation and poor concentration, do not typically respond to standard schizophrenia treatment. Treatment for schizophrenia has evolved hardly at all since 1989, when the now widely used class of drugs known as atypical antipsychotics were discovered.
A new, extensive meta-analysis from the University Medical Centre in Utrecht, Netherlands on research concerning the combination of anti-inflammatories and antipsychotics for schizophrenia treatment suggests that drugs like aspirin may be useful for improving the effectiveness of these front-line medications for schizophrenia.
The Many Uses of Salicylic Acid
The analgesic (pain-relieving) properties of salicylic acid have been formally recognized since the mid-1700s, and acetylsalicylic acid has been manufactured and sold as aspirin since 1899. In addition to being used as a pain reliever and anti-inflammatory, aspirin is also widely used as a blood thinner to help prevent the formation of blood clots that could result in strokes or heart attacks. Newer research even suggests that aspirin may help prevent colorectal cancer and certain other types of cancers. It is one of the most widely used medications in the world.
A number of studies in recent years have drawn connections between schizophrenia and the immune system and have suggested that anti-inflammatory medications may improve treatment of this illness. The immune system has been linked to various psychiatric disorders, and research has associated the HLA gene system in particular (a system that plays a controlling role in various aspects of the immune system) with schizophrenia.
The Dutch study looked at a range of the best of these studies—all double-blind, randomized controlled trials—in order to determine if there was strong evidence in favor of the use of anti-inflammatory medications in combination with antipsychotic drugs. They found that a number of anti-inflammatory agents improved the results of antipsychotic drugs for schizophrenic patients.
Only Certain Drugs Showed Positive Effects
The meta-analysis did reveal that not all anti-inflammatory agents improved treatment of schizophrenia. Aspirin, estrogen hormones and an antioxidant called fluimucil showed strong results, but other anti-inflammatory agents such as fatty acids, celecoxib and minocyline did not seem to have any effect.
Understanding the mechanisms by which certain anti-inflammatories improve schizophrenia treatment will help researchers understand why certain agents show positive results and others do not. It will also help improve overall understanding of schizophrenia so that treatment can continue to be refined.
These findings were presented at the European College of Neuropsychopharmacology conference in Berlin, Germany.